Provider Demographics
NPI:1699011007
Name:KRAAYEVELD, ABBY ZOE (MA, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:ABBY
Middle Name:ZOE
Last Name:KRAAYEVELD
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:618 N 44TH AVE
Mailing Address - Street 2:
Mailing Address - City:RIDGEFIELD
Mailing Address - State:WA
Mailing Address - Zip Code:98642-7839
Mailing Address - Country:US
Mailing Address - Phone:360-903-0573
Mailing Address - Fax:360-326-2202
Practice Address - Street 1:8221 NE HAZEL DELL AVE
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98665-8153
Practice Address - Country:US
Practice Address - Phone:360-903-0573
Practice Address - Fax:360-326-2202
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-13
Last Update Date:2022-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALL60158862235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist