Provider Demographics
NPI:1487854220
Name:SLOANE, JEANINE C (MA)
Entity Type:Individual
Prefix:
First Name:JEANINE
Middle Name:C
Last Name:SLOANE
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:JEANINE
Other - Middle Name:C
Other - Last Name:HARTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:538 NORTH 5TH AVE
Mailing Address - Street 2:
Mailing Address - City:SEQUIM
Mailing Address - State:WA
Mailing Address - Zip Code:98382-3079
Mailing Address - Country:US
Mailing Address - Phone:360-681-7500
Mailing Address - Fax:360-681-7717
Practice Address - Street 1:538 NORTH 5TH AVE
Practice Address - Street 2:
Practice Address - City:SEQUIM
Practice Address - State:WA
Practice Address - Zip Code:98382-3079
Practice Address - Country:US
Practice Address - Phone:360-681-7500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-19
Last Update Date:2008-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALD00003873231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist