Provider Demographics
NPI:1174817274
Name:VANDERLINDE, LAURA (SLP)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:
Last Name:VANDERLINDE
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6117 N ATLANTIC ST
Mailing Address - Street 2:APT 2
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99205-6274
Mailing Address - Country:US
Mailing Address - Phone:509-280-7365
Mailing Address - Fax:
Practice Address - Street 1:400 S 43RD ST
Practice Address - Street 2:
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98055-5714
Practice Address - Country:US
Practice Address - Phone:425-251-5165
Practice Address - Fax:425-656-4028
Is Sole Proprietor?:No
Enumeration Date:2011-06-06
Last Update Date:2018-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
235Z00000X
CA15262355S0801X
WALL60632599235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
No2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant