Provider Demographics
NPI:1033461538
Name:TIPTON, CINDY (SLP, MAED)
Entity Type:Individual
Prefix:MS
First Name:CINDY
Middle Name:
Last Name:TIPTON
Suffix:
Gender:F
Credentials:SLP, MAED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7102 40TH ST W
Mailing Address - Street 2:
Mailing Address - City:UNIVERSITY PLACE
Mailing Address - State:WA
Mailing Address - Zip Code:98466-5015
Mailing Address - Country:US
Mailing Address - Phone:253-566-5680
Mailing Address - Fax:
Practice Address - Street 1:7102 40TH ST W
Practice Address - Street 2:
Practice Address - City:UNIVERSITY PLACE
Practice Address - State:WA
Practice Address - Zip Code:98466-5015
Practice Address - Country:US
Practice Address - Phone:253-566-5680
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-10-08
Last Update Date:2012-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA235Z00000XMedicaid