Provider Demographics
NPI:1083134852
Name:HOWARD, AUTUMN ROSE
Entity Type:Individual
Prefix:
First Name:AUTUMN
Middle Name:ROSE
Last Name:HOWARD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:AUTUMN
Other - Middle Name:ROSE
Other - Last Name:COOK-BIGGERT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:43705 SE 149TH ST
Mailing Address - Street 2:
Mailing Address - City:NORTH BEND
Mailing Address - State:WA
Mailing Address - Zip Code:98045-9322
Mailing Address - Country:US
Mailing Address - Phone:206-488-8022
Mailing Address - Fax:
Practice Address - Street 1:209 MAIN AVE S
Practice Address - Street 2:
Practice Address - City:NORTH BEND
Practice Address - State:WA
Practice Address - Zip Code:98045
Practice Address - Country:US
Practice Address - Phone:245-888-3347
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-22
Last Update Date:2019-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALL60672031235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist