Healthcare Provider Details

I. General information

NPI: 1730559840
Provider Name (Legal Business Name): KENDRE HOWLAND SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/01/2015
Last Update Date: 10/01/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

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

IV. Provider business mailing address

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

V. Phone/Fax

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

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSI60598418
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: