Provider Demographics
NPI:1841824216
Name:THURSTON, SAWNDRA
Entity type:Individual
Prefix:
First Name:SAWNDRA
Middle Name:
Last Name:THURSTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5705 MASTERS LN SE APT C103
Mailing Address - Street 2:
Mailing Address - City:LACEY
Mailing Address - State:WA
Mailing Address - Zip Code:98513-4133
Mailing Address - Country:US
Mailing Address - Phone:360-225-5466
Mailing Address - Fax:
Practice Address - Street 1:3285 FERGUSON ST SW
Practice Address - Street 2:
Practice Address - City:TUMWATER
Practice Address - State:WA
Practice Address - Zip Code:98512-6143
Practice Address - Country:US
Practice Address - Phone:360-943-1907
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-25
Last Update Date:2025-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health