Provider Demographics
NPI:1477088128
Name:KROGMAN, AMY
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:
Last Name:KROGMAN
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 1:420 W SMITH ST
Mailing Address - Street 2:APT. 336
Mailing Address - City:KENT
Mailing Address - State:WA
Mailing Address - Zip Code:98032-4423
Mailing Address - Country:US
Mailing Address - Phone:715-773-1621
Mailing Address - Fax:
Practice Address - Street 1:516 23RD AVE SE
Practice Address - Street 2:
Practice Address - City:PUYALLUP
Practice Address - State:WA
Practice Address - Zip Code:98372-4659
Practice Address - Country:US
Practice Address - Phone:253-845-6631
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-01
Last Update Date:2017-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist