Provider Demographics
NPI:1134464605
Name:GIENGER, ELIZABETH (SLPA)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:GIENGER
Suffix:
Gender:F
Credentials:SLPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3713 TAHOMA PL W
Mailing Address - Street 2:
Mailing Address - City:UNIVERSITY PLACE
Mailing Address - State:WA
Mailing Address - Zip Code:98466-2144
Mailing Address - Country:US
Mailing Address - Phone:253-278-4282
Mailing Address - Fax:
Practice Address - Street 1:5802 20TH ST E
Practice Address - Street 2:
Practice Address - City:FIFE
Practice Address - State:WA
Practice Address - Zip Code:98424-2030
Practice Address - Country:US
Practice Address - Phone:253-517-1000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-12-10
Last Update Date:2012-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WASP 602364442355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant