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NPI Code Detail

MEDICARE: SUSAN OBLAK

MEDICARE:   SUSAN  OBLAK
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
1235Z00000XSpeech-Language PathologistLL000003473WA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1LL00003473OTHERWALICENSED SPEECH LANGUAGE PATHOLOGIST

General Provider Information

NPI Number : 1891108577
Entity Type Code : Individual
Provider Name (Legal Business Name) : SUSAN OBLAK
Provider Business Mailing Address
First Line : 1113 IRENE PL NE
Second Line :
City : BAINBRIDGE ISLAND
State : WA
Zip : 98110-1933
Country : US
Telephone Number : 206-393-8523
Fax Number :
Provider Business Practice Location Address
First Line : 8117 STONE AVE N
Second Line :
City : SEATTLE
State : WA
Zip : 98103-4414
Country : US
Telephone Number : 206-535-8876
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/10/2014
Last Update Date : 06/10/2014

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Directions to “ SUSAN OBLAK ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.