Provider Demographics
NPI:1417174244
Name:MCCLAIN, PATRICIA ANN (MS,CCC-SLP-L)
Entity Type:Individual
Prefix:MS
First Name:PATRICIA
Middle Name:ANN
Last Name:MCCLAIN
Suffix:
Gender:F
Credentials:MS,CCC-SLP-L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10815 115TH CT NE APT A107
Mailing Address - Street 2:
Mailing Address - City:KIRKLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98033-5072
Mailing Address - Country:US
Mailing Address - Phone:630-988-2561
Mailing Address - Fax:630-985-0213
Practice Address - Street 1:10815 115TH CT NE APT A107
Practice Address - Street 2:
Practice Address - City:KIRKLAND
Practice Address - State:WA
Practice Address - Zip Code:98033-5072
Practice Address - Country:US
Practice Address - Phone:630-988-2561
Practice Address - Fax:630-985-0213
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-20
Last Update Date:2015-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALL60558585235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist