Most Relevant Information
Provider Data
| NPI Number: | 1003397647 |
| Provider Name: | SARA CAMILLE BANEGAS |
| Entity Type: | Individual |
| Taxonomy Code: | 103TS0200X |
| Specialty: | Psychologist |
| License Number: | 550480E |
Most Important Dates
| Enumeration Date: | 08/22/2018 |
| Last Updated: | 08/22/2018 |
Provider Practice Location
5108 260TH ST E
GRAHAM
WA
983389609
Practice Location Phone/Fax
| Phone: | 6026531445 |
| Fax: |
Provider Mailing Location
5636 A ST
TACOMA
WA
984087505
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |