MEDICARE: MRS. KAYLA LEE WASHA 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	SLP.0002471	CO

General Provider Information

NPI Number	:	1164951638
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. KAYLA LEE WASHA MS CCC-SLP

Provider Business Mailing Address
First Line	:	625 FLAGLER RD
Second Line	:
City	:	FORT COLLINS
State	:	CO
Zip	:	80525-7030
Country	:	US
Telephone Number	:	308-882-6376
Fax Number	:

Provider Business Practice Location Address
First Line	:	625 FLAGLER RD
Second Line	:
City	:	FORT COLLINS
State	:	CO
Zip	:	80525-7030
Country	:	US
Telephone Number	:	308-882-6376
Fax Number	:

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

Provider Enumeration Date	:	06/08/2017
Last Update Date	:	07/21/2022

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