Provider Demographics
NPI:1447760707
Name:TOWNSEND, STEFANIE CATHERINE HELENE (SI 60788477)
Entity Type:Individual
Prefix:
First Name:STEFANIE
Middle Name:CATHERINE HELENE
Last Name:TOWNSEND
Suffix:
Gender:F
Credentials:SI 60788477
Other - Prefix:
Other - First Name:STEFANIE
Other - Middle Name:CATHERINE HELENE
Other - Last Name:WATSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:352 W LOOKOUT RIDGE DR APT 101
Mailing Address - Street 2:
Mailing Address - City:WASHOUGAL
Mailing Address - State:WA
Mailing Address - Zip Code:98671-8002
Mailing Address - Country:US
Mailing Address - Phone:425-275-3229
Mailing Address - Fax:
Practice Address - Street 1:4855 EVERGREEN WAY
Practice Address - Street 2:
Practice Address - City:WASHOUGAL
Practice Address - State:WA
Practice Address - Zip Code:98671-9176
Practice Address - Country:US
Practice Address - Phone:360-954-3000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-10-01
Last Update Date:2017-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60788477235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist