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General NPI Number Information
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NPI Number | 1871074005
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Entity Type | Organization
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Legal Business Name | THE SPEECH ORCHARD, LLC
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Dates
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Enumeration Date | 08/25/2018
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Last Update Date | 08/01/2019
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Provider Practice Location Address
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Address Line | 23931 HIGHWAY 99 UNIT 103
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City | EDMONDS
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State | WA
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Zip | 98026-9259
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Country | US
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Telephone | 206-751-6266
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Fax | 206-519-6695
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Provider Business Mailing Address
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Address Line | 16320 FREMONT PL N
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City | SHORELINE
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State | WA
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Zip | 98133-5611
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Country | US
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Telephone | 206-751-6266
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | HALEY SHADOAN
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Credential | MS CCC-SLP
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Telephone | 206-751-6266
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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 | LL60707476
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License Number State | WA
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