Provider Demographics
NPI:1417022245
Name:HUNNICUTT, KARI LYNN (MS, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:KARI
Middle Name:LYNN
Last Name:HUNNICUTT
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 1:8250 SE FERNBROOK LN
Mailing Address - Street 2:
Mailing Address - City:PORT ORCHARD
Mailing Address - State:WA
Mailing Address - Zip Code:98366-8821
Mailing Address - Country:US
Mailing Address - Phone:360-871-6230
Mailing Address - Fax:
Practice Address - Street 1:1008 BETHEL AVE STE E
Practice Address - Street 2:
Practice Address - City:PORT ORCHARD
Practice Address - State:WA
Practice Address - Zip Code:98366-4236
Practice Address - Country:US
Practice Address - Phone:360-871-2076
Practice Address - Fax:360-895-0203
Is Sole Proprietor?:No
Enumeration Date:2006-11-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALL00003892235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8420622Medicaid