Provider Demographics
NPI:1811151285
Name:RAY, DAVID L (MA CCC SLP)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:L
Last Name:RAY
Suffix:
Gender:M
Credentials:MA CCC SLP
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Mailing Address - Street 1:2607 BRIDGEPORT WAY W
Mailing Address - Street 2:#1-H PROFESSIONAL HEARING AND SPEECH SERVICES INC
Mailing Address - City:UNIVERSITY PLACE
Mailing Address - State:WA
Mailing Address - Zip Code:98466-4725
Mailing Address - Country:US
Mailing Address - Phone:253-460-5088
Mailing Address - Fax:253-460-5454
Practice Address - Street 1:2607 BRIDGEPORT WAY W
Practice Address - Street 2:#1-H PROFESSIONAL HEARING AND SPEECH SERVICES INC
Practice Address - City:UNIVERSITY PLACE
Practice Address - State:WA
Practice Address - Zip Code:98466-4725
Practice Address - Country:US
Practice Address - Phone:253-460-5088
Practice Address - Fax:253-460-5454
Is Sole Proprietor?:No
Enumeration Date:2008-07-15
Last Update Date:2008-07-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WALL00003786235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist