Provider Demographics
NPI:1790945681
Name:RASMUSSEN, JOANNA (MS CCC-SLP)
Entity Type:Individual
Prefix:
First Name:JOANNA
Middle Name:
Last Name:RASMUSSEN
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11510 NW 29TH PL
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98685-3485
Mailing Address - Country:US
Mailing Address - Phone:360-831-2706
Mailing Address - Fax:
Practice Address - Street 1:2121 NE 139TH ST
Practice Address - Street 2:BUILDING A, SUITE #200
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98686-2316
Practice Address - Country:US
Practice Address - Phone:360-487-1780
Practice Address - Fax:360-487-1779
Is Sole Proprietor?:No
Enumeration Date:2008-06-13
Last Update Date:2010-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ID808103400Medicaid
IDSP058OtherBLUE CROSS OF IDAHO