Healthcare Provider Details

I. General information

NPI: 1386113587
Provider Name (Legal Business Name): ALICIA PITT SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ALICIA K SAUNDERS SLP

II. Dates (important events)

Enumeration Date: 11/16/2018
Last Update Date: 11/16/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10324 CANYON RD E STE 203
PUYALLUP WA
98373-1013
US

IV. Provider business mailing address

10324 CANYON RD E STE 203
PUYALLUP WA
98373-1013
US

V. Phone/Fax

Practice location:
  • Phone: 253-471-2727
  • Fax: 253-471-2730
Mailing address:
  • Phone: 253-471-2727
  • Fax: 253-471-2730

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSI60888694
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: