Healthcare Provider Details

I. General information

NPI: 1831028257
Provider Name (Legal Business Name): PAITON LEE HAEBERLE C-SLPA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/14/2026
Last Update Date: 05/14/2026
Certification Date: 05/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

528 E SPOKANE BLVD
SPOKANE WA
99202-5081
US

IV. Provider business mailing address

28 E SAPPHIRE LN
SPOKANE WA
99208-6028
US

V. Phone/Fax

Practice location:
  • Phone: 509-316-0219
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2355S0801X
TaxonomySpeech-Language Assistant
License Number3371460
License Number StateID
# 2
Primary TaxonomyY
Taxonomy Code2355S0801X
TaxonomySpeech-Language Assistant
License Number61537666
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: