Provider Demographics
NPI:1174274195
Name:STAVANA, MARLOW (MS, CF-SLP)
Entity Type:Individual
Prefix:
First Name:MARLOW
Middle Name:
Last Name:STAVANA
Suffix:
Gender:F
Credentials:MS, CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:901 E 31ST AVE
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99203-3107
Mailing Address - Country:US
Mailing Address - Phone:509-818-5550
Mailing Address - Fax:
Practice Address - Street 1:123 E 37TH AVE
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99203-7000
Practice Address - Country:US
Practice Address - Phone:509-354-3200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-11
Last Update Date:2022-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist