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General NPI Number Information
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NPI Number | 1851434427
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Entity Type | Individual
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Provider Name | MARY R SAUTER CCC-SLP
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Gender | Female
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Dates
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Enumeration Date | 02/14/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 9503 19TH AVE E
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City | TACOMA
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State | WA
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Zip | 98445-5557
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Country | US
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Telephone | 253-471-2727
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Fax | 253-471-2730
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Provider Business Mailing Address
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Address Line | 2379 S 6TH ST
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City | FORT LEWIS
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State | WA
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Zip | 98433-1057
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Country | US
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Telephone | 253-267-5559
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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 | LL00004218
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License Number State | WA
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