MEDICARE: MS. MARILYN LEE PHILPOTT MA, CCC-SLP

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
1	235Z00000X	Speech-Language Pathologist	LL000003865	WA

General Provider Information

NPI Number	:	1699029058
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. MARILYN LEE PHILPOTT MA, CCC-SLP

Provider Business Mailing Address
First Line	:	10807 66TH PL NE
Second Line	:
City	:	LAKE STEVENS
State	:	WA
Zip	:	98258-9090
Country	:	US
Telephone Number	:	425-418-7036
Fax Number	:

Provider Business Practice Location Address
First Line	:	1237 W MAIN ST
Second Line	:
City	:	MONROE
State	:	WA
Zip	:	98272-2028
Country	:	US
Telephone Number	:	360-794-1061
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/06/2012
Last Update Date	:	02/06/2017

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Directions to “ MS. MARILYN LEE PHILPOTT MA, CCC-SLP” Practice Location

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