Healthcare Provider Details

I. General information

NPI: 1558013581
Provider Name (Legal Business Name): CLARA JANE ELLIOTT M.S. CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CLARA JANE HANSON M.S. CCC-SLP

II. Dates (important events)

Enumeration Date: 01/20/2022
Last Update Date: 10/06/2026
Certification Date: 10/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 S 289TH ST # WA
FEDERAL WAY WA
98003-3709
US

IV. Provider business mailing address

37422 323RD AVE SE
ENUMCLAW WA
98022-8106
US

V. Phone/Fax

Practice location:
  • Phone: 253-945-3439
  • Fax:
Mailing address:
  • Phone: 253-347-7418
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number61186055
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: