Provider Demographics
NPI:1215581459
Name:WHITMAN, GRACE (CCC-SLP)
Entity Type:Individual
Prefix:
First Name:GRACE
Middle Name:
Last Name:WHITMAN
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:GRACE
Other - Middle Name:
Other - Last Name:HIEGEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CCC-SLP
Mailing Address - Street 1:9576 RIDGETOP BLVD NW STE L101
Mailing Address - Street 2:
Mailing Address - City:SILVERDALE
Mailing Address - State:WA
Mailing Address - Zip Code:98383-8554
Mailing Address - Country:US
Mailing Address - Phone:253-851-0007
Mailing Address - Fax:
Practice Address - Street 1:9576 RIDGETOP BLVD NW STE L101
Practice Address - Street 2:
Practice Address - City:SILVERDALE
Practice Address - State:WA
Practice Address - Zip Code:98383-8554
Practice Address - Country:US
Practice Address - Phone:253-851-0007
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-25
Last Update Date:2024-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WASLPI.SI.60978076235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist