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General NPI Number Information
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NPI Number | 1699011007
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Entity Type | Individual
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Provider Name | ABBY ZOE KRAAYEVELD MA, CCC-SLP
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Gender | Female
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Dates
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Enumeration Date | 12/13/2012
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Last Update Date | 01/19/2022
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Provider Practice Location Address
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Address Line | 8221 NE HAZEL DELL AVE
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City | VANCOUVER
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State | WA
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Zip | 98665-8153
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Country | US
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Telephone | 360-903-0573
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Fax | 360-326-2202
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Provider Business Mailing Address
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Address Line | 618 N 44TH AVE
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City | RIDGEFIELD
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State | WA
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Zip | 98642-7839
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Country | US
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Telephone | 360-903-0573
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Fax | 360-326-2202
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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 | LL60158862
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License Number State | WA
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