Provider Demographics
NPI:1720011174
Name:RATCLIFF, ANGELA CHERIE (MS, CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:ANGELA
Middle Name:CHERIE
Last Name:RATCLIFF
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:13618 59TH AVE SE
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98208-9403
Mailing Address - Country:US
Mailing Address - Phone:425-258-7378
Mailing Address - Fax:425-258-7406
Practice Address - Street 1:916 PACIFIC AVE
Practice Address - Street 2:OUTPATIENT REHABILITATION, 2ND FLOOR, PACIFIC CAMPUS
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98201-4147
Practice Address - Country:US
Practice Address - Phone:425-258-7378
Practice Address - Fax:425-258-7406
Is Sole Proprietor?:No
Enumeration Date:2006-07-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALL00001764235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WALL00001764OtherLICENSE