Healthcare Provider Details

I. General information

NPI: 1124848833
Provider Name (Legal Business Name): GUADALUPE GARCIA SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/16/2024
Last Update Date: 08/27/2026
Certification Date: 08/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

125 S WEHE AVE
PASCO WA
99301-4331
US

IV. Provider business mailing address

1127 W JAN ST
PASCO WA
99301-3546
US

V. Phone/Fax

Practice location:
  • Phone: 509-543-8046
  • Fax:
Mailing address:
  • Phone: 509-528-8943
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number61368831
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: