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General NPI Number Information
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NPI Number | 1952679201
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Entity Type | Organization
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Legal Business Name | ACCESS SPEECH & LANGUAGE THERAPY, INC.
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Dates
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Enumeration Date | 12/01/2011
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Last Update Date | 12/01/2011
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Provider Practice Location Address
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Address Line | 401 OLYMPIA AVE NE STE 120
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City | RENTON
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State | WA
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Zip | 98056-4117
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Country | US
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Telephone | 206-200-3636
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Fax |
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Provider Business Mailing Address
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Address Line | 6217 NE 4TH CT
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City | RENTON
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State | WA
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Zip | 98059-4573
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Country | US
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Telephone | 206-200-3636
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | KRISTI WOLSWIJK
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Credential |
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Telephone | 206-200-3636
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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 | LL00003550
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License Number State | WA
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