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NPI 1912063983

NPI 1912063983 : AMANDA E SEPE CCC-SLP : WOODINVILLE, WA

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General NPI Number Information
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    NPI Number           |    1912063983
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    Entity Type          |    Individual 
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    Provider Name        |    AMANDA E SEPE CCC-SLP
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    12/27/2006
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    Last Update Date     |    07/08/2007
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Provider Practice Location Address
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    Address Line         |    17311 135TH AVE NE STE C200 
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    City                 |    WOODINVILLE
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    State                |    WA
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    Zip                  |    98072-3564
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    Country              |    US
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    Telephone            |    206-713-5293
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    18008 176TH AVE NE 
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    City                 |    WOODINVILLE
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    State                |    WA
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    Zip                  |    98072-9633
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    Country              |    US
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    Telephone            |    206-713-5293
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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       |    LL00002647
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    License Number State |    WA
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