Healthcare Provider Details

I. General information

NPI: 1770180861
Provider Name (Legal Business Name): CAITLIN MARTIN CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: CAITLIN TALBOTT CF-SLP

II. Dates (important events)

Enumeration Date: 10/02/2020
Last Update Date: 03/22/2023
Certification Date: 03/21/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8507 NE 8TH WAY
VANCOUVER WA
98664-1980
US

IV. Provider business mailing address

7810 NE 67TH CIR
VANCOUVER WA
98662-4221
US

V. Phone/Fax

Practice location:
  • Phone: 360-254-5335
  • Fax:
Mailing address:
  • Phone: 360-975-0008
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberCF7185
License Number StateNM
# 2
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberLL61192747
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: