Provider Demographics
NPI:1144396276
Name:VAN ZEYL, ANTHONY J (MS, CCC-SLP)
Entity Type:Individual
Prefix:MR
First Name:ANTHONY
Middle Name:J
Last Name:VAN ZEYL
Suffix:
Gender:M
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:19401 40TH AVE W
Mailing Address - Street 2:SUITE 310
Mailing Address - City:LYNNWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98036-4612
Mailing Address - Country:US
Mailing Address - Phone:425-582-2473
Mailing Address - Fax:425-582-2475
Practice Address - Street 1:19401 40TH AVE W
Practice Address - Street 2:SUITE 310
Practice Address - City:LYNNWOOD
Practice Address - State:WA
Practice Address - Zip Code:98036-4612
Practice Address - Country:US
Practice Address - Phone:425-582-2473
Practice Address - Fax:425-582-2475
Is Sole Proprietor?:No
Enumeration Date:2006-11-28
Last Update Date:2008-02-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WALL00003598235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA7028319Medicaid
WA12012793OtherASHA NUMBER
WA8383846Medicaid
WA7985798OtherAETNA INS. NUMBER