MEDICARE: MS. JOSELYN KAY EITEMILLER M.A., 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	LL00001532	WA

General Provider Information

NPI Number	:	1265638480
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. JOSELYN KAY EITEMILLER M.A., CCC-SLP

Provider Business Mailing Address
First Line	:	4537 40TH AVE SW
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98116-4214
Country	:	US
Telephone Number	:	206-935-0124
Fax Number	:

Provider Business Practice Location Address
First Line	:	4537 40TH AVE SW
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98116-4214
Country	:	US
Telephone Number	:	206-935-0124
Fax Number	:

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

Provider Enumeration Date	:	06/25/2007
Last Update Date	:	07/08/2007

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Directions to “ MS. JOSELYN KAY EITEMILLER M.A., CCC-SLP” Practice Location

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