Provider Demographics
NPI:1568535698
Name:NEWMAN-KENNEDY, LINDA LEE (PHD, CCC)
Entity Type:Individual
Prefix:DR
First Name:LINDA
Middle Name:LEE
Last Name:NEWMAN-KENNEDY
Suffix:
Gender:F
Credentials:PHD, CCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1501 PARKER WAY
Mailing Address - Street 2:SUITE 106
Mailing Address - City:MOUNT VERNON
Mailing Address - State:WA
Mailing Address - Zip Code:98273-2599
Mailing Address - Country:US
Mailing Address - Phone:360-856-0829
Mailing Address - Fax:
Practice Address - Street 1:1501 PARKER WAY
Practice Address - Street 2:SUITE 106
Practice Address - City:MOUNT VERNON
Practice Address - State:WA
Practice Address - Zip Code:98273-2599
Practice Address - Country:US
Practice Address - Phone:360-856-0829
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALL00001164235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8369167Medicaid