Provider Demographics
NPI:1619516671
Name:EGGLESTON, SCHOTZI (SLP-CCC)
Entity type:Individual
Prefix:
First Name:SCHOTZI
Middle Name:
Last Name:EGGLESTON
Suffix:
Gender:F
Credentials:SLP-CCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1211 DAYTON AVE NE
Mailing Address - Street 2:
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98056-1219
Mailing Address - Country:US
Mailing Address - Phone:206-999-8280
Mailing Address - Fax:
Practice Address - Street 1:1211 DAYTON AVE NE
Practice Address - Street 2:
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98056-7192
Practice Address - Country:US
Practice Address - Phone:206-999-8280
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-12-22
Last Update Date:2023-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146.015137235Z00000X
WALL61244821235Z00000X
235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist