Provider Demographics
NPI:1750875993
Name:KATZ, CARLIN (CCC-SLP)
Entity type:Individual
Prefix:
First Name:CARLIN
Middle Name:
Last Name:KATZ
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7202 NE HIGHWAY 99 STE 106
Mailing Address - Street 2:#283
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98665-2115
Mailing Address - Country:US
Mailing Address - Phone:503-563-0883
Mailing Address - Fax:
Practice Address - Street 1:7202 NE HIGHWAY 99 STE 106
Practice Address - Street 2:#283
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98665-2115
Practice Address - Country:US
Practice Address - Phone:503-563-0883
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-20
Last Update Date:2020-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALL60844740235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist