Healthcare Provider Details

I. General information

NPI: 1225750045
Provider Name (Legal Business Name): ERICA INTILANGELO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/19/2022
Last Update Date: 06/15/2026
Certification Date: 06/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3810 PLAZA WAY
KENNEWICK WA
99338-2722
US

IV. Provider business mailing address

451 WESTCLIFFE BLVD APT E138
RICHLAND WA
99352-9328
US

V. Phone/Fax

Practice location:
  • Phone: 509-221-7000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSLPI.SI.70096641
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: