Provider Demographics
NPI:1033648357
Name:BUDKE, ELIZABETH GRAHAM (CCC-SLP)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:GRAHAM
Last Name:BUDKE
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:337 W 14TH AVE
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99204-3617
Mailing Address - Country:US
Mailing Address - Phone:1509-847-3373
Mailing Address - Fax:
Practice Address - Street 1:7411 N NEVADA ST
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99208-5518
Practice Address - Country:US
Practice Address - Phone:509-489-2273
Practice Address - Fax:509-482-3041
Is Sole Proprietor?:No
Enumeration Date:2017-06-09
Last Update Date:2017-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALL60753272235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist