Provider Demographics
NPI:1518211259
Name:GALVAN WALI, HAYDEE GUADALUPE (MA, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:HAYDEE
Middle Name:GUADALUPE
Last Name:GALVAN WALI
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:MISS
Other - First Name:HAYDEE
Other - Middle Name:GUADALUPE
Other - Last Name:GALVAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA, CCC-SLP
Mailing Address - Street 1:19653 15TH AVE NE
Mailing Address - Street 2:
Mailing Address - City:SHORELINE
Mailing Address - State:WA
Mailing Address - Zip Code:98155-1120
Mailing Address - Country:US
Mailing Address - Phone:702-406-0860
Mailing Address - Fax:
Practice Address - Street 1:9600 HOLLY DR
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98204-2607
Practice Address - Country:US
Practice Address - Phone:425-366-2529
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-11-02
Last Update Date:2012-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALL 60302228235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist