Provider Demographics
NPI:1801260138
Name:WESCOTT, KRISTIN (MA, CCC-A)
Entity type:Individual
Prefix:
First Name:KRISTIN
Middle Name:
Last Name:WESCOTT
Suffix:
Gender:F
Credentials:MA, CCC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1818 SOUTH UNION AVE
Mailing Address - Street 2:#2-C
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98405
Mailing Address - Country:US
Mailing Address - Phone:253-627-7567
Mailing Address - Fax:253-627-4778
Practice Address - Street 1:1818 SOUTH UNION AVE
Practice Address - Street 2:#2-C
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98405
Practice Address - Country:US
Practice Address - Phone:253-627-7567
Practice Address - Fax:253-627-4778
Is Sole Proprietor?:No
Enumeration Date:2015-11-24
Last Update Date:2016-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALD00001136231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist