Provider Demographics
NPI:1770318131
Name:NELSON, ASHLEY NICHOLE WITTIG
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:NICHOLE WITTIG
Last Name:NELSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17017 431ST AVE SE
Mailing Address - Street 2:
Mailing Address - City:NORTH BEND
Mailing Address - State:WA
Mailing Address - Zip Code:98045-9650
Mailing Address - Country:US
Mailing Address - Phone:360-536-5802
Mailing Address - Fax:
Practice Address - Street 1:9050 384TH AVE SE
Practice Address - Street 2:
Practice Address - City:SNOQUALMIE
Practice Address - State:WA
Practice Address - Zip Code:98065-9637
Practice Address - Country:US
Practice Address - Phone:425-428-1343
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-05
Last Update Date:2024-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist