Provider Demographics
NPI:1528588316
Name:SMAGALA-DEVANE, COLLEEN ELLEN
Entity Type:Individual
Prefix:
First Name:COLLEEN
Middle Name:ELLEN
Last Name:SMAGALA-DEVANE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9217 NE 14TH WAY
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98664-6405
Mailing Address - Country:US
Mailing Address - Phone:562-233-3102
Mailing Address - Fax:
Practice Address - Street 1:740 NE DALLAS ST
Practice Address - Street 2:
Practice Address - City:CAMAS
Practice Address - State:WA
Practice Address - Zip Code:98607-2058
Practice Address - Country:US
Practice Address - Phone:360-834-5055
Practice Address - Fax:360-817-2489
Is Sole Proprietor?:No
Enumeration Date:2017-06-22
Last Update Date:2017-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist