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General NPI Number Information
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NPI Number | 1134860299
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Entity Type | Individual
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Provider Name | CASSANDRA CARINA VILLARREAL MS, CCC-SLP
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Gender | Female
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Dates
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Enumeration Date | 04/05/2022
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Last Update Date | 09/13/2023
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Provider Practice Location Address
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Address Line | 13056 SE 76TH ST
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City | NEWCASTLE
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State | WA
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Zip | 98056-4159
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Country | US
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Telephone | 425-903-3530
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Fax |
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Provider Business Mailing Address
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Address Line | 4040 26TH AVE SW APT 122
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City | SEATTLE
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State | WA
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Zip | 98106-1267
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Country | US
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Telephone | 254-423-6966
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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 |
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License Number State | WA
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