Provider Demographics
NPI:1831285634
Name:COLE WILSON, DONNA ANN (MS CCC)
Entity Type:Individual
Prefix:MS
First Name:DONNA
Middle Name:ANN
Last Name:COLE WILSON
Suffix:
Gender:F
Credentials:MS CCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12550 AURORA AVE N
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98133-8036
Mailing Address - Country:US
Mailing Address - Phone:206-826-1028
Mailing Address - Fax:206-826-1128
Practice Address - Street 1:12550 AURORA AVE N
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98133-8036
Practice Address - Country:US
Practice Address - Phone:206-826-1028
Practice Address - Fax:206-826-1128
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2014-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALL00001048235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist