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General NPI Number Information
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NPI Number | 1629624549
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Entity Type | Individual
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Provider Name | KAREN ALEXANDRA PACL CCC-SLP
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Gender | Female
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Dates
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Enumeration Date | 08/15/2019
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Last Update Date | 08/15/2019
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Provider Practice Location Address
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Address Line | 9576 RIDGETOP BLVD NW STE L101
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City | SILVERDALE
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State | WA
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Zip | 98383-8554
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Country | US
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Telephone | 360-447-9120
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Fax |
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Provider Business Mailing Address
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Address Line | 400 WASHINGTON AVE UNIT 401
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City | BREMERTON
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State | WA
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Zip | 98337-1462
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Country | US
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Telephone | 479-445-0912
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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 | LL60981260
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License Number State | WA
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