Provider Demographics
NPI:1427600279
Name:GLANTZ, AMBER CAROLYN (MA CCC-SLP)
Entity Type:Individual
Prefix:
First Name:AMBER
Middle Name:CAROLYN
Last Name:GLANTZ
Suffix:
Gender:F
Credentials:MA CCC-SLP
Other - Prefix:
Other - First Name:AMBER
Other - Middle Name:
Other - Last Name:MICHAELIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2815 EASTLAKE AVE E STE 200
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98102-3086
Mailing Address - Country:US
Mailing Address - Phone:206-322-5433
Mailing Address - Fax:
Practice Address - Street 1:2815 EASTLAKE AVE E STE 200
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98102-3086
Practice Address - Country:US
Practice Address - Phone:206-322-5433
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-11
Last Update Date:2024-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist