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General NPI Number Information
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NPI Number | 1679182646
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Entity Type | Individual
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Provider Name | LAYNE MARIE RIDLEY CCC-SLP
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Gender | Female
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Dates
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Enumeration Date | 07/27/2020
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Last Update Date | 11/05/2025
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Provider Practice Location Address
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Address Line | 20307 102ND AVE SE
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City | KENT
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State | WA
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Zip | 98031-5500
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Country | US
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Telephone | 253-232-3246
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Fax |
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Provider Business Mailing Address
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Address Line | 533 HARVARD AVE E APT 402
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City | SEATTLE
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State | WA
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Zip | 98102-4952
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Country | US
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Telephone | 253-232-3246
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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 | LL61539745
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License Number State | WA
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