Provider Demographics
NPI:1457755936
Name:MYERS, DEBORAH (MA, CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:DEBORAH
Middle Name:
Last Name:MYERS
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:134 MARION AVE N
Mailing Address - Street 2:
Mailing Address - City:BREMERTON
Mailing Address - State:WA
Mailing Address - Zip Code:98312-3542
Mailing Address - Country:US
Mailing Address - Phone:360-473-4580
Mailing Address - Fax:360-473-1043
Practice Address - Street 1:3250 SPRUCE AVE
Practice Address - Street 2:
Practice Address - City:BREMERTON
Practice Address - State:WA
Practice Address - Zip Code:98310-3554
Practice Address - Country:US
Practice Address - Phone:360-473-4580
Practice Address - Fax:360-473-1043
Is Sole Proprietor?:No
Enumeration Date:2014-10-13
Last Update Date:2016-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA12159877235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist