Healthcare Provider Details

I. General information

NPI: 1528514858
Provider Name (Legal Business Name): PAZ DIAZ-WILLIAMS PHD., CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: PAZ DIAZ-WILLIAMS PHD

II. Dates (important events)

Enumeration Date: 08/28/2016
Last Update Date: 10/03/2024
Certification Date: 09/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

MADIGAN ARMY MEDICAL CENTER 9040 JACKSON AVE
TACOMA WA
98433
US

IV. Provider business mailing address

6693 JACKSON AVE JOINT BASE LEWIS-MCCHORD
TACOMA WA
98433
US

V. Phone/Fax

Practice location:
  • Phone: 253-968-2252
  • Fax:
Mailing address:
  • Phone: 253-968-7918
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number14089589
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: