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General NPI Number Information
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NPI Number | 1972013977
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Entity Type | Organization
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Legal Business Name | CLEARTALK SPEECH AND LANGUAGE THERAPY, LLC
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Dates
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Enumeration Date | 10/04/2017
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Last Update Date | 05/12/2022
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Provider Practice Location Address
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Address Line | 16703 SE MCGILLIVRAY BLVD STE 170
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City | VANCOUVER
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State | WA
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Zip | 98683-4301
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Country | US
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Telephone | 360-989-7347
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Fax | 888-974-0252
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Provider Business Mailing Address
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Address Line | 17920 NE 198TH CT
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City | BRUSH PRAIRIE
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State | WA
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Zip | 98606-8806
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Country | US
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Telephone | 503-567-6326
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Fax | 888-974-0252
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Authorized Official
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Title or Position | PROVIDER
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Name | KENDRA HOLLOWAY
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Credential | SLP
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Telephone | 503-567-6326
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number |
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License Number State |
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