Provider Demographics
NPI:1336283696
Name:MUENCH, ELLEN MARIE (SLP)
Entity Type:Individual
Prefix:MRS
First Name:ELLEN
Middle Name:MARIE
Last Name:MUENCH
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:PO BOX 1911
Mailing Address - Street 2:
Mailing Address - City:MARYSVILLE
Mailing Address - State:WA
Mailing Address - Zip Code:98270-1911
Mailing Address - Country:US
Mailing Address - Phone:360-631-3458
Mailing Address - Fax:775-417-5986
Practice Address - Street 1:315 MAIN ST STE A1
Practice Address - Street 2:
Practice Address - City:MOUNT VERNON
Practice Address - State:WA
Practice Address - Zip Code:98273-3889
Practice Address - Country:US
Practice Address - Phone:360-631-3458
Practice Address - Fax:775-417-5986
Is Sole Proprietor?:No
Enumeration Date:2007-02-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALL00004241235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist