Provider Demographics
NPI:1104252808
Name:SACH, TERESA LYN (LCSW)
Entity type:Individual
Prefix:MS
First Name:TERESA
Middle Name:LYN
Last Name:SACH
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:TERESA
Other - Middle Name:LYN
Other - Last Name:BURGESS-SACH
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LICSW
Mailing Address - Street 1:14606 SE 334TH ST
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:WA
Mailing Address - Zip Code:98092-9237
Mailing Address - Country:US
Mailing Address - Phone:206-992-3317
Mailing Address - Fax:
Practice Address - Street 1:MADIGAN ARMY MEDICAL CENTER 9040 JACKSON AVE
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98431-9237
Practice Address - Country:US
Practice Address - Phone:253-967-4273
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-25
Last Update Date:2020-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA000095411041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical