Provider Demographics
NPI:1720100134
Name:HERRINGTON, PAULA BECKETT (MS CCC-SLP)
Entity Type:Individual
Prefix:
First Name:PAULA
Middle Name:BECKETT
Last Name:HERRINGTON
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23620 63RD AVE SW
Mailing Address - Street 2:
Mailing Address - City:VASHON
Mailing Address - State:WA
Mailing Address - Zip Code:98070-7253
Mailing Address - Country:US
Mailing Address - Phone:253-874-9300
Mailing Address - Fax:
Practice Address - Street 1:1705 S 324TH PL
Practice Address - Street 2:
Practice Address - City:FEDERAL WAY
Practice Address - State:WA
Practice Address - Zip Code:98003-8504
Practice Address - Country:US
Practice Address - Phone:253-874-9300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALL00001984235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist