Healthcare Provider Details
I. General information
NPI: 1598528986
Provider Name (Legal Business Name): PLAYFUL PATHWAYS SPEECH THERAPY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/30/2024
Last Update Date: 04/10/2025
Certification Date: 04/10/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
19123 13TH AVE SE
BOTHELL WA
98012-6866
US
IV. Provider business mailing address
19123 13TH AVE SE
BOTHELL WA
98012-6866
US
V. Phone/Fax
- Phone: 480-431-0775
- Fax:
- Phone: 480-431-0775
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 235Z00000X |
| Taxonomy | Speech-Language Pathologist |
| License Number | |
| License Number State | |
VII. Legacy identifiers
For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:
VIII. Authorized Official
Name:
ASWATHY
PRASHANTH
Title or Position: SPEECH LANGUAGE PATHOLOGIST
Credential: CCC-SLP
Phone: 480-431-0775