Provider Demographics
NPI:1619566544
Name:COLLADO, SANNA INGER (BA)
Entity type:Individual
Prefix:
First Name:SANNA
Middle Name:INGER
Last Name:COLLADO
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:SANNAH
Other - Middle Name:INGER
Other - Last Name:VARGAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4227 S MERIDIAN STE D
Mailing Address - Street 2:PMB 40
Mailing Address - City:PUYALLUP
Mailing Address - State:WA
Mailing Address - Zip Code:98373
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:22014 43RD AVE E
Practice Address - Street 2:
Practice Address - City:SPANAWAY
Practice Address - State:WA
Practice Address - Zip Code:98387-6886
Practice Address - Country:US
Practice Address - Phone:253-232-9645
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-14
Last Update Date:2025-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALF61618193106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty