Provider Demographics
NPI:1710223078
Name:PELLEGRINI, CRISTY
Entity Type:Individual
Prefix:MS
First Name:CRISTY
Middle Name:
Last Name:PELLEGRINI
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 1:2005 127TH DR NE
Mailing Address - Street 2:
Mailing Address - City:LAKE STEVENS
Mailing Address - State:WA
Mailing Address - Zip Code:98258-8623
Mailing Address - Country:US
Mailing Address - Phone:425-512-2185
Mailing Address - Fax:
Practice Address - Street 1:2005 127TH DR NE
Practice Address - Street 2:
Practice Address - City:LAKE STEVENS
Practice Address - State:WA
Practice Address - Zip Code:98258-8623
Practice Address - Country:US
Practice Address - Phone:425-512-2185
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-13
Last Update Date:2012-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant