MEDICARE: MRS. HEATHER B. TONDER

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	SLPI.SI.60521580	WA
2	235Z00000X	Speech-Language Pathologist	ESA 491183J	WA

General Provider Information

NPI Number	:	1689051831
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. HEATHER B. TONDER

Provider Business Mailing Address
First Line	:	2818 HAYTON ST
Second Line	:
City	:	BREMERTON
State	:	WA
Zip	:	98310-5427
Country	:	US
Telephone Number	:	360-440-7758
Fax Number	:

Provider Business Practice Location Address
First Line	:	1230 BAY ST
Second Line	:
City	:	PORT ORCHARD
State	:	WA
Zip	:	98366-5214
Country	:	US
Telephone Number	:	253-851-0007
Fax Number	:

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

Provider Enumeration Date	:	04/27/2015
Last Update Date	:	04/27/2015

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Directions to “ MRS. HEATHER B. TONDER ” Practice Location

Language	Start Address	Practice Location

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