Provider Demographics
NPI:1316011430
Name:STROUTSOS, ALICE W (MS CCC, SLP)
Entity Type:Individual
Prefix:MRS
First Name:ALICE
Middle Name:W
Last Name:STROUTSOS
Suffix:
Gender:F
Credentials:MS CCC, SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19324 40TH AVE W.
Mailing Address - Street 2:SUITE A
Mailing Address - City:LYNNWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98036
Mailing Address - Country:US
Mailing Address - Phone:425-658-2400
Mailing Address - Fax:425-526-5550
Practice Address - Street 1:19324 40TH AVE W.
Practice Address - Street 2:SUITE A
Practice Address - City:LYNNWOOD
Practice Address - State:WA
Practice Address - Zip Code:98036
Practice Address - Country:US
Practice Address - Phone:425-658-2400
Practice Address - Fax:425-526-5550
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-20
Last Update Date:2019-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALL00001326235Z00000X
235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA00088617OtherASHA NUMBER
WA4230STOtherREGENCE BS NUMBER
WA7095664Medicaid
WAAS98036OtherAETNA INSURANCE NUMBER