Provider Demographics
NPI:1851015150
Name:WAYMENT, AUDREY GAYLE
Entity Type:Individual
Prefix:
First Name:AUDREY
Middle Name:GAYLE
Last Name:WAYMENT
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 1:13446 GREENWOOD AVE N APT A
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98133-7367
Mailing Address - Country:US
Mailing Address - Phone:951-692-2562
Mailing Address - Fax:
Practice Address - Street 1:4301 S PINE ST STE 301
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98409-7206
Practice Address - Country:US
Practice Address - Phone:253-476-6500
Practice Address - Fax:253-476-6547
Is Sole Proprietor?:No
Enumeration Date:2022-09-29
Last Update Date:2023-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WASLPI.SI.61349416235Z00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist