Provider Demographics
NPI:1467823583
Name:FOLKERTS, TESSA CLAIRE (SLP)
Entity Type:Individual
Prefix:MISS
First Name:TESSA
Middle Name:CLAIRE
Last Name:FOLKERTS
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17265 SE WAX RD
Mailing Address - Street 2:
Mailing Address - City:COVINGTON
Mailing Address - State:WA
Mailing Address - Zip Code:98042-9102
Mailing Address - Country:US
Mailing Address - Phone:253-981-4133
Mailing Address - Fax:
Practice Address - Street 1:17265 SE WAX RD STE 105
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:WA
Practice Address - Zip Code:98042-9102
Practice Address - Country:US
Practice Address - Phone:253-981-4133
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-10-15
Last Update Date:2023-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALL61193721235Z00000X
FLSI 26932355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
No2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant