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General NPI Number Information
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NPI Number | 1013268986
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Entity Type | Individual
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Provider Name | ANN S LEWIS B.S.
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Gender | Female
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Dates
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Enumeration Date | 10/02/2012
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Last Update Date | 10/02/2012
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Provider Practice Location Address
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Address Line | 1202 S 76TH ST
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City | TACOMA
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State | WA
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Zip | 98408-2907
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Country | US
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Telephone | 253-571-4579
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 237 3414 150TH AVE KPS
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City | LAKEBAY
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State | WA
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Zip | 98349-0237
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Country | US
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Telephone | 253-884-5898
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 021602 CL00001234
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License Number State | WA
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