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NPI Code Detail

MEDICARE: SOUND SPEECH PATHOLOGY, LLC

MEDICARE: SOUND SPEECH PATHOLOGY, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1235Z00000XSpeech-Language Pathologist

General Provider Information

NPI Number : 1396493193
Entity Type Code : Organization
Provider Name (Legal Business Name) : SOUND SPEECH PATHOLOGY, LLC
Provider Business Mailing Address
First Line : 9838 SE CORNELL RD
Second Line :
City : PORT ORCHARD
State : WA
Zip : 98366-8955
Country : US
Telephone Number : 360-375-4300
Fax Number : 360-824-6838
Provider Business Practice Location Address
First Line : 2497 BETHEL RD SE
Second Line :
City : PORT ORCHARD
State : WA
Zip : 98366-2489
Country : US
Telephone Number : 360-375-4300
Fax Number : 360-824-6838
Authorized Official
Title or Position : CEO
Name : CASSANDRA LEE COOK
Credential : M. ED., CCC-SLP
Telephone Number : 360-375-4300
Provider Enumeration Date : 03/11/2022
Last Update Date : 03/11/2022

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Directions to “SOUND SPEECH PATHOLOGY, LLC ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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