Healthcare Provider Details

I. General information

NPI: 1053223768
Provider Name (Legal Business Name): VICTORIA P KAUWE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/18/2026
Last Update Date: 09/18/2026
Certification Date: 09/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

303 BRIDGE ST STE 3
CLARKSTON WA
99403-2921
US

IV. Provider business mailing address

PO BOX 13
ASOTIN WA
99402-0013
US

V. Phone/Fax

Practice location:
  • Phone: 509-202-0966
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSLPI.SI.70168712
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: