Provider Demographics
NPI:1851803472
Name:DAWSON, MALLORY MEGAN (CF-SLP)
Entity Type:Individual
Prefix:
First Name:MALLORY
Middle Name:MEGAN
Last Name:DAWSON
Suffix:
Gender:F
Credentials:CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:509 19TH AVE E APT 301
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98112-4078
Mailing Address - Country:US
Mailing Address - Phone:971-340-7246
Mailing Address - Fax:
Practice Address - Street 1:325 9TH AVE # 359818
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98104-2420
Practice Address - Country:US
Practice Address - Phone:206-744-8126
Practice Address - Fax:206-744-5734
Is Sole Proprietor?:No
Enumeration Date:2017-11-05
Last Update Date:2017-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WASI60807252235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist