Provider Demographics
NPI:1417110008
Name:TSENG, ELENITA (MS CCC-SLP)
Entity Type:Individual
Prefix:
First Name:ELENITA
Middle Name:
Last Name:TSENG
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 1:11 W ALOHA ST
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98119-3743
Mailing Address - Country:US
Mailing Address - Phone:206-301-4446
Mailing Address - Fax:
Practice Address - Street 1:11 WEST ALOHA STREET
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98119
Practice Address - Country:US
Practice Address - Phone:206-301-4446
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-03
Last Update Date:2010-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALL00004692235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist