Provider Demographics
NPI:1437545258
Name:NUSTAD, ASHLEY ANN (MS, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:ASHLEY
Middle Name:ANN
Last Name:NUSTAD
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 1:21331 139TH PL SE
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:WA
Mailing Address - Zip Code:98272-9730
Mailing Address - Country:US
Mailing Address - Phone:425-877-9245
Mailing Address - Fax:
Practice Address - Street 1:1237 W MAIN ST
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:WA
Practice Address - Zip Code:98272-2028
Practice Address - Country:US
Practice Address - Phone:360-794-1061
Practice Address - Fax:360-805-9491
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-08
Last Update Date:2015-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist