Provider Demographics
NPI:1104106939
Name:TAPSAK, SARA ELISABETH (PSYD)
Entity type:Individual
Prefix:DR
First Name:SARA
Middle Name:ELISABETH
Last Name:TAPSAK
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1740 NW MAPLE ST
Mailing Address - Street 2:SUITE 210
Mailing Address - City:ISSAQUAH
Mailing Address - State:WA
Mailing Address - Zip Code:98027-8127
Mailing Address - Country:US
Mailing Address - Phone:206-659-9393
Mailing Address - Fax:
Practice Address - Street 1:1740 NW MAPLE ST
Practice Address - Street 2:SUITE 210
Practice Address - City:ISSAQUAH
Practice Address - State:WA
Practice Address - Zip Code:98027-8127
Practice Address - Country:US
Practice Address - Phone:206-659-9393
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-24
Last Update Date:2016-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPY60675707103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent