Provider Demographics
NPI:1740554781
Name:HATTON, SPENCER ANDY SHANNON (MA, CCC-SLP)
Entity type:Individual
Prefix:MR
First Name:SPENCER
Middle Name:ANDY SHANNON
Last Name:HATTON
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Gender:M
Credentials:MA, CCC-SLP
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Mailing Address - Street 1:1871 NW GILMAN BLVD
Mailing Address - Street 2:SUITE 2
Mailing Address - City:ISSAQUAH
Mailing Address - State:WA
Mailing Address - Zip Code:98027-8116
Mailing Address - Country:US
Mailing Address - Phone:425-657-0620
Mailing Address - Fax:425-677-7415
Practice Address - Street 1:1871 NW GILMAN BLVD
Practice Address - Street 2:SUITE 2
Practice Address - City:ISSAQUAH
Practice Address - State:WA
Practice Address - Zip Code:98027-8116
Practice Address - Country:US
Practice Address - Phone:425-657-0620
Practice Address - Fax:425-677-7415
Is Sole Proprietor?:No
Enumeration Date:2012-03-07
Last Update Date:2012-03-07
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Provider Licenses
StateLicense IDTaxonomies
WALL60179994235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist