Provider Demographics
NPI:1588612808
Name:ZARELLA, LEE JAMES (MA, CCC-A)
Entity Type:Individual
Prefix:
First Name:LEE
Middle Name:JAMES
Last Name:ZARELLA
Suffix:
Gender:M
Credentials:MA, CCC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1608 S J ST FL 5
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98405-4930
Mailing Address - Country:US
Mailing Address - Phone:253-426-6731
Mailing Address - Fax:253-215-1094
Practice Address - Street 1:1608 S J ST FL 5
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98405-4930
Practice Address - Country:US
Practice Address - Phone:253-426-6731
Practice Address - Fax:253-215-1094
Is Sole Proprietor?:No
Enumeration Date:2006-05-05
Last Update Date:2021-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALD00001211231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA223217OtherSTATE L&I
WA0208481OtherSTATE L&I
WA0208483OtherSTATE L&I
WA8941431OtherSTATE CRIME VICTIMS
WA1044829Medicaid
WAG8860196Medicare PIN
WA0208481OtherSTATE L&I