Provider Demographics
NPI:1497084206
Name:WILKEN, VANESSA (MS, CF-SLP)
Entity Type:Individual
Prefix:
First Name:VANESSA
Middle Name:
Last Name:WILKEN
Suffix:
Gender:F
Credentials:MS, CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:626 120TH ST SW
Mailing Address - Street 2:B201
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98005-3077
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:626 120TH ST SW
Practice Address - Street 2:B201
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98005-3077
Practice Address - Country:US
Practice Address - Phone:425-556-6330
Practice Address - Fax:425-556-6325
Is Sole Proprietor?:No
Enumeration Date:2009-12-08
Last Update Date:2009-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WASI60121723235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist