Provider Demographics
NPI:1710500814
Name:FOUNDATION SPEECH LANGUAGE LEARNING
Entity Type:Organization
Organization Name:FOUNDATION SPEECH LANGUAGE LEARNING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH LANGUAGE PATHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:SUAN
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:BARNHART
Authorized Official - Suffix:
Authorized Official - Credentials:MS, CCC-SLP
Authorized Official - Phone:253-242-3499
Mailing Address - Street 1:633 S MACARTHUR ST
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98465-1819
Mailing Address - Country:US
Mailing Address - Phone:206-437-0426
Mailing Address - Fax:
Practice Address - Street 1:7406 27TH ST W STE 24A
Practice Address - Street 2:
Practice Address - City:UNIVERSITY PLACE
Practice Address - State:WA
Practice Address - Zip Code:98466-4636
Practice Address - Country:US
Practice Address - Phone:253-242-3499
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-22
Last Update Date:2020-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
No174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1710500814Medicaid