MEDICARE: MS. ANGELA BARBER MS CCC SLP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	LL 60277293	WA
2	235Z00000X	Speech-Language Pathologist	15046	OR

General Provider Information

NPI Number	:	1114355450
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ANGELA BARBER MS CCC SLP

Provider Business Mailing Address
First Line	:	8911 MERIDIAN AVE N
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98103-4148
Country	:	US
Telephone Number	:	415-933-1923
Fax Number	:

Provider Business Practice Location Address
First Line	:	8911 MERIDIAN AVE N
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98103-4148
Country	:	US
Telephone Number	:	415-933-1923
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/24/2013
Last Update Date	:	10/24/2013

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