Provider Demographics
NPI:1376843102
Name:WILLNER, PIERA M (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:PIERA
Middle Name:M
Last Name:WILLNER
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:PIERA
Other - Middle Name:J
Other - Last Name:MILLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, CCC-SLP
Mailing Address - Street 1:4839 S BRANDON ST
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98118-2359
Mailing Address - Country:US
Mailing Address - Phone:206-735-2818
Mailing Address - Fax:206-763-0352
Practice Address - Street 1:4839 S BRANDON ST
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98118-2359
Practice Address - Country:US
Practice Address - Phone:206-735-2818
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-27
Last Update Date:2013-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALL60178719235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist