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General NPI Number Information
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NPI Number | 1275399735
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Entity Type | Organization
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Legal Business Name | MELINDA SIDOR, SLP INC
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Dates
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Enumeration Date | 02/22/2024
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Last Update Date | 02/22/2024
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Provider Practice Location Address
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Address Line | 2915 MCCARVER ST STE 100
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City | TACOMA
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State | WA
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Zip | 98403-3392
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Country | US
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Telephone | 253-691-6813
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Fax |
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Provider Business Mailing Address
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Address Line | 2606 21ST ST SW
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City | PUYALLUP
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State | WA
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Zip | 98373-1392
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Country | US
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Telephone | 253-691-6813
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Fax |
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Authorized Official
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Title or Position | SPEECH LANGUAGE PATHOLOGIST
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Name | MELINDA SIDOR
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Credential | CCC-SLP
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Telephone | 253-691-6813
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0700X
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Taxonomy Name | Hearing and Speech Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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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 |
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