Provider Demographics
NPI:1508950346
Name:AJAM, JANNA M (SLP)
Entity Type:Individual
Prefix:MRS
First Name:JANNA
Middle Name:M
Last Name:AJAM
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:JANNA
Other - Middle Name:M
Other - Last Name:PETERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:SLP
Mailing Address - Street 1:1100 9TH AVE
Mailing Address - Street 2:MAILSTOP H4 PMR
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98101-2756
Mailing Address - Country:US
Mailing Address - Phone:206-341-0461
Mailing Address - Fax:206-223-6472
Practice Address - Street 1:1100 9TH AVE
Practice Address - Street 2:MAILSTOP H4 PMR
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98101-2756
Practice Address - Country:US
Practice Address - Phone:206-341-0461
Practice Address - Fax:206-223-6472
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2007-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALL00004163235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist