=====================================================
General NPI Number Information
=====================================================
NPI Number | 1972413748
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ABIDE SPEECH AND LANGUAGE, PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/11/2026
-----------------------------------------------------
Last Update Date | 09/11/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 8665 BERTHUSEN RD
-----------------------------------------------------
City | LYNDEN
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 98264-9714
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 360-603-8624
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 8665 BERTHUSEN RD
-----------------------------------------------------
City | LYNDEN
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 98264-9714
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 360-603-8624
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | AUTHORIZED STAFF CONSOLE
-----------------------------------------------------
Name | ABIGAIL CLARKE
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 360-603-8624
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 235Z00000X
-----------------------------------------------------
Taxonomy Name | Speech-Language Pathologist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------