Provider Demographics
NPI:1003157736
Name:TAYLOR, SANDRA WEIS (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:SANDRA
Middle Name:WEIS
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:SANDRA
Other - Middle Name:KAY
Other - Last Name:WEIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2012 NW WILLOW DR
Mailing Address - Street 2:
Mailing Address - City:CAMAS
Mailing Address - State:WA
Mailing Address - Zip Code:98607-7400
Mailing Address - Country:US
Mailing Address - Phone:360-833-2299
Mailing Address - Fax:
Practice Address - Street 1:2012 NW WILLOW DR
Practice Address - Street 2:
Practice Address - City:CAMAS
Practice Address - State:WA
Practice Address - Zip Code:98607-7400
Practice Address - Country:US
Practice Address - Phone:360-833-2299
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-05
Last Update Date:2013-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist