Healthcare Provider Details

I. General information

NPI: 1629987409
Provider Name (Legal Business Name): PACIFIC SPEECH AND NEUROLOGICAL REHABILITATION, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/05/2026
Last Update Date: 09/27/2026
Certification Date: 09/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2024 CATON WAY SW STE 201
OLYMPIA WA
98502-8201
US

IV. Provider business mailing address

5815 LACEY BLVD SE UNIT 3747
LACEY WA
98503-2459
US

V. Phone/Fax

Practice location:
  • Phone: 360-490-7720
  • Fax:
Mailing address:
  • Phone: 360-490-7720
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: APRIL BRODAHL
Title or Position: OWNER/THERAPIST
Credential: CCC-SLP
Phone: 360-490-7720