MEDICARE: TROY ISAKSON

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 60021453	WA

General Provider Information

NPI Number	:	1831415439
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TROY ISAKSON

Provider Business Mailing Address
First Line	:	1952 E 7000 S STE 100
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84121-6878
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	9827 N NEVADA ST
Second Line	:
City	:	SPOKANE
State	:	WA
Zip	:	99218-3407
Country	:	US
Telephone Number	:	509-468-7000
Fax Number	:	801-495-5312

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

Provider Enumeration Date	:	04/08/2010
Last Update Date	:	04/08/2010

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Directions to “ TROY ISAKSON ” Practice Location

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