Provider Demographics
NPI:1508130188
Name:LYNNWOOD SPEECH & LANGUAGE SERVICES
Entity Type:Organization
Organization Name:LYNNWOOD SPEECH & LANGUAGE SERVICES
Other - Org Name:SUSAN E. STEWART
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SPEECH & LANGUAGE PATHOLOGIST
Authorized Official - Prefix:MS
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:STEWART
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:425-582-2473
Mailing Address - Street 1:19401 40TH AVE W
Mailing Address - Street 2:SUITE 310
Mailing Address - City:LYNNWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98036-4612
Mailing Address - Country:US
Mailing Address - Phone:425-582-2473
Mailing Address - Fax:425-582-2475
Practice Address - Street 1:19401 40TH AVE W
Practice Address - Street 2:SUITE 310
Practice Address - City:LYNNWOOD
Practice Address - State:WA
Practice Address - Zip Code:98036-4612
Practice Address - Country:US
Practice Address - Phone:425-582-2473
Practice Address - Fax:425-582-2475
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-29
Last Update Date:2012-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALL00002780235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1356409510OtherNPI NUMBER