Provider Demographics
NPI:1073791836
Name:SARA S KEMP SLP INC.
Entity Type:Organization
Organization Name:SARA S KEMP SLP INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SARA
Authorized Official - Middle Name:S
Authorized Official - Last Name:KEMP
Authorized Official - Suffix:
Authorized Official - Credentials:SLP
Authorized Official - Phone:360-357-3339
Mailing Address - Street 1:2401 BRISTOL CT SW # D-103
Mailing Address - Street 2:
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98502-6003
Mailing Address - Country:US
Mailing Address - Phone:360-357-3339
Mailing Address - Fax:360-528-3018
Practice Address - Street 1:2401 BRISTOL CT SW # D-103
Practice Address - Street 2:
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98502-6003
Practice Address - Country:US
Practice Address - Phone:360-357-3339
Practice Address - Fax:360-528-3018
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-04
Last Update Date:2008-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA7102320Medicaid