Provider Demographics
NPI:1336331487
Name:HOUSER-HUNT, JO ELLEN MARIE (MS CCC SLP/A)
Entity Type:Individual
Prefix:
First Name:JO ELLEN
Middle Name:MARIE
Last Name:HOUSER-HUNT
Suffix:
Gender:F
Credentials:MS CCC SLP/A
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:12608 115TH AVENUE CT E
Mailing Address - Street 2:
Mailing Address - City:PUYALLUP
Mailing Address - State:WA
Mailing Address - Zip Code:98374-3182
Mailing Address - Country:US
Mailing Address - Phone:903-799-8504
Mailing Address - Fax:903-793-1203
Practice Address - Street 1:12698 115TH AVE CT E
Practice Address - Street 2:
Practice Address - City:PUYALLUP
Practice Address - State:WA
Practice Address - Zip Code:98374
Practice Address - Country:US
Practice Address - Phone:903-799-8504
Practice Address - Fax:903-793-1203
Is Sole Proprietor?:No
Enumeration Date:2007-08-13
Last Update Date:2014-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX50325235Z00000X, 235Z00000X
WALL60451617235Z00000X
AR184235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist