Provider Demographics
NPI:1114294857
Name:DAMBOISE, ALISON LESLIE (SLP-CCC)
Entity Type:Individual
Prefix:MRS
First Name:ALISON
Middle Name:LESLIE
Last Name:DAMBOISE
Suffix:
Gender:F
Credentials:SLP-CCC
Other - Prefix:MS
Other - First Name:ALISON
Other - Middle Name:LESLIE
Other - Last Name:DAMBOISE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MS, CCC-SLP
Mailing Address - Street 1:629 AVENUE D
Mailing Address - Street 2:
Mailing Address - City:SNOHOMISH
Mailing Address - State:WA
Mailing Address - Zip Code:98290-2330
Mailing Address - Country:US
Mailing Address - Phone:425-268-4118
Mailing Address - Fax:425-953-2534
Practice Address - Street 1:629 AVENUE D
Practice Address - Street 2:
Practice Address - City:SNOHOMISH
Practice Address - State:WA
Practice Address - Zip Code:98290-2330
Practice Address - Country:US
Practice Address - Phone:425-268-4118
Practice Address - Fax:425-953-2534
Is Sole Proprietor?:No
Enumeration Date:2011-11-23
Last Update Date:2012-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALL60171480235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist