Healthcare Provider Details

I. General information

NPI: 1366678047
Provider Name (Legal Business Name): EILEEN BIANAMARA CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: EILEEN CLARE SISK CCC-SLP

II. Dates (important events)

Enumeration Date: 06/08/2009
Last Update Date: 08/29/2026
Certification Date: 08/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4910 PHINNEY AVE N
SEATTLE WA
98103-6347
US

IV. Provider business mailing address

7541 19TH AVE NE
SEATTLE WA
98115-4431
US

V. Phone/Fax

Practice location:
  • Phone: 206-634-1347
  • Fax:
Mailing address:
  • Phone: 713-724-1082
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSLP.LL.60621140
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: