Provider Demographics
NPI:1043797236
Name:NEXT LEVEL SPEECH THERAPY, P.C.
Entity Type:Organization
Organization Name:NEXT LEVEL SPEECH THERAPY, P.C.
Other - Org Name:NEXT LEVEL SPEECH THERAPY PC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:DOUGLAS
Authorized Official - Last Name:SANDERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:206-489-4559
Mailing Address - Street 1:8050 MUKILTEO SPEEDWAY UNIT 209
Mailing Address - Street 2:
Mailing Address - City:MUKILTEO
Mailing Address - State:WA
Mailing Address - Zip Code:98275-7009
Mailing Address - Country:US
Mailing Address - Phone:206-489-4559
Mailing Address - Fax:
Practice Address - Street 1:12221 VILLAGE CENTER PL STE 101
Practice Address - Street 2:
Practice Address - City:MUKILTEO
Practice Address - State:WA
Practice Address - Zip Code:98275-6080
Practice Address - Country:US
Practice Address - Phone:206-489-4559
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-20
Last Update Date:2023-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty
No2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language AssistantGroup - Single Specialty