Provider Demographics
NPI:1497195150
Name:BURROWS, MARIYA (MS, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:MARIYA
Middle Name:
Last Name:BURROWS
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:MS
Other - First Name:MARIYA
Other - Middle Name:
Other - Last Name:LEGESSE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CCC-SLP
Mailing Address - Street 1:10016 EDMONDS WAY
Mailing Address - Street 2:STE C-230
Mailing Address - City:EDMONDS
Mailing Address - State:WA
Mailing Address - Zip Code:98020-5107
Mailing Address - Country:US
Mailing Address - Phone:425-409-9351
Mailing Address - Fax:
Practice Address - Street 1:10016 EDMONDS WAY
Practice Address - Street 2:STE C-230
Practice Address - City:EDMONDS
Practice Address - State:WA
Practice Address - Zip Code:98020-5107
Practice Address - Country:US
Practice Address - Phone:425-409-9351
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-26
Last Update Date:2016-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA501859COtherOSPI, PROFESSIONAL EDUCATION & CERTIFICATION
WA14058654OtherASHA
WALL60508598OtherWASHINGTON STATE DEPARTMENT OF HEALTH