Healthcare Provider Details

I. General information

NPI: 1740968486
Provider Name (Legal Business Name): NIDHI PATEL M.S. CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/11/2023
Last Update Date: 06/22/2026
Certification Date: 06/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2510 6TH AVE UNIT 509
SEATTLE WA
98121-5126
US

IV. Provider business mailing address

2510 6TH AVE UNIT 509
SEATTLE WA
98121-5126
US

V. Phone/Fax

Practice location:
  • Phone: 319-621-7820
  • Fax:
Mailing address:
  • Phone: 319-621-7820
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSLP.LL.70007319
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number40399
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: