Provider Demographics
NPI:1437587797
Name:FOREMAN, KAREN LYNNE
Entity Type:Individual
Prefix:MS
First Name:KAREN
Middle Name:LYNNE
Last Name:FOREMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:611 E AGATE RD
Mailing Address - Street 2:
Mailing Address - City:SHELTON
Mailing Address - State:WA
Mailing Address - Zip Code:98584-7306
Mailing Address - Country:US
Mailing Address - Phone:360-427-2931
Mailing Address - Fax:360-427-2933
Practice Address - Street 1:611 E AGATE RD
Practice Address - Street 2:
Practice Address - City:SHELTON
Practice Address - State:WA
Practice Address - Zip Code:98584-7306
Practice Address - Country:US
Practice Address - Phone:360-427-2931
Practice Address - Fax:360-427-2933
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-24
Last Update Date:2013-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALL00003012235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist