Provider Demographics
NPI:1124574975
Name:BOWEN, MELINDA BUTTLES (MA, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:MELINDA
Middle Name:BUTTLES
Last Name:BOWEN
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:MELINDA
Other - Middle Name:KATHERINE
Other - Last Name:BUTTLES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:920 S 2ND ST
Mailing Address - Street 2:
Mailing Address - City:MOUNT VERNON
Mailing Address - State:WA
Mailing Address - Zip Code:98273-4205
Mailing Address - Country:US
Mailing Address - Phone:360-428-6122
Mailing Address - Fax:
Practice Address - Street 1:920 S 2ND ST
Practice Address - Street 2:
Practice Address - City:MOUNT VERNON
Practice Address - State:WA
Practice Address - Zip Code:98273-4205
Practice Address - Country:US
Practice Address - Phone:360-428-6122
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-31
Last Update Date:2016-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist