Provider Demographics
NPI:1821821299
Name:CLEGERN-SILER, SUZANNE (MA, CCC-SLP)
Entity type:Individual
Prefix:
First Name:SUZANNE
Middle Name:
Last Name:CLEGERN-SILER
Suffix:
Gender:F
Credentials:MA, 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:PO BOX 336
Mailing Address - Street 2:
Mailing Address - City:WOODINVILLE
Mailing Address - State:WA
Mailing Address - Zip Code:98072-0336
Mailing Address - Country:US
Mailing Address - Phone:408-813-3826
Mailing Address - Fax:
Practice Address - Street 1:21727 NE 141ST ST
Practice Address - Street 2:
Practice Address - City:WOODINVILLE
Practice Address - State:WA
Practice Address - Zip Code:98077-5849
Practice Address - Country:US
Practice Address - Phone:408-813-3826
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-21
Last Update Date:2024-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALL60754308235Z00000X
CA14109235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist