Provider Demographics
NPI:1417685520
Name:WHISPERING CREEK SPEECH PATHOLOGY SERVICES PLLC
Entity Type:Organization
Organization Name:WHISPERING CREEK SPEECH PATHOLOGY SERVICES PLLC
Other - Org Name:WHISPERING CREEK SPEECH PATHOLOGY SERVICES PLLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SPEECH PATHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:MONICA
Authorized Official - Middle Name:CLARE
Authorized Official - Last Name:MANZA
Authorized Official - Suffix:
Authorized Official - Credentials:SLP
Authorized Official - Phone:509-202-5987
Mailing Address - Street 1:1103 N OLSON HILL CT
Mailing Address - Street 2:
Mailing Address - City:MEDICAL LAKE
Mailing Address - State:WA
Mailing Address - Zip Code:99022-8850
Mailing Address - Country:US
Mailing Address - Phone:509-202-5987
Mailing Address - Fax:509-299-5293
Practice Address - Street 1:1801 W BROADWAY AVE
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99201-1819
Practice Address - Country:US
Practice Address - Phone:509-202-5987
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-08
Last Update Date:2022-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty