MEDICARE: KARI ANN WEED 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	LL60051927	WA

General Provider Information

NPI Number	:	1174768642
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KARI ANN WEED MS, CCC-SLP

Provider Business Mailing Address
First Line	:	13514 434TH AVE SE
Second Line	:
City	:	NORTH BEND
State	:	WA
Zip	:	98045-9669
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	13514 434TH AVE SE
Second Line	:
City	:	NORTH BEND
State	:	WA
Zip	:	98045-9669
Country	:	US
Telephone Number	:	206-355-6535
Fax Number	:

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

Provider Enumeration Date	:	12/11/2008
Last Update Date	:	11/27/2012

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