Provider Demographics
NPI:1255772448
Name:GOLDSCHMIT, SUZANNE MONDA (MA SLP)
Entity type:Individual
Prefix:
First Name:SUZANNE
Middle Name:MONDA
Last Name:GOLDSCHMIT
Suffix:
Gender:F
Credentials:MA SLP
Other - Prefix:
Other - First Name:SUZANNE
Other - Middle Name:
Other - Last Name:MONDA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:13607 174TH AVE NE
Mailing Address - Street 2:
Mailing Address - City:REDMOND
Mailing Address - State:WA
Mailing Address - Zip Code:98052-2167
Mailing Address - Country:US
Mailing Address - Phone:425-941-8258
Mailing Address - Fax:
Practice Address - Street 1:18500 156TH AVE NE STE 201
Practice Address - Street 2:
Practice Address - City:WOODINVILLE
Practice Address - State:WA
Practice Address - Zip Code:98072-4459
Practice Address - Country:US
Practice Address - Phone:425-844-1176
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-16
Last Update Date:2013-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALL00002459235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist