Provider Demographics
NPI:1255009015
Name:WEHRMEISTER, KALLAN
Entity type:Individual
Prefix:
First Name:KALLAN
Middle Name:
Last Name:WEHRMEISTER
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 1:24120 VAN RY BLVD STE 400
Mailing Address - Street 2:
Mailing Address - City:MOUNTLAKE TERRACE
Mailing Address - State:WA
Mailing Address - Zip Code:98043-5459
Mailing Address - Country:US
Mailing Address - Phone:425-412-1019
Mailing Address - Fax:
Practice Address - Street 1:24120 VAN RY BLVD STE 400
Practice Address - Street 2:
Practice Address - City:MOUNTLAKE TERRACE
Practice Address - State:WA
Practice Address - Zip Code:98043-5459
Practice Address - Country:US
Practice Address - Phone:425-412-1019
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-05
Last Update Date:2024-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WASP613740452355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant