Provider Demographics
NPI:1629598313
Name:CONNER, NARA R (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:NARA
Middle Name:R
Last Name:CONNER
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:NARA
Other - Middle Name:R
Other - Last Name:MITCHELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, CCC-SLP
Mailing Address - Street 1:4421 75TH ST SW
Mailing Address - Street 2:
Mailing Address - City:MUKILTEO
Mailing Address - State:WA
Mailing Address - Zip Code:98275-2510
Mailing Address - Country:US
Mailing Address - Phone:612-819-6805
Mailing Address - Fax:
Practice Address - Street 1:4430 TALBOT RD S
Practice Address - Street 2:
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98055-6218
Practice Address - Country:US
Practice Address - Phone:425-226-7500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-22
Last Update Date:2017-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALL60715024235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist