Provider Demographics
NPI:1952778953
Name:SUMNER, KRISTINE E (SLP)
Entity Type:Individual
Prefix:
First Name:KRISTINE
Middle Name:E
Last Name:SUMNER
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10811 SE KENT KANGLEY RD
Mailing Address - Street 2:
Mailing Address - City:KENT
Mailing Address - State:WA
Mailing Address - Zip Code:98030-7108
Mailing Address - Country:US
Mailing Address - Phone:253-854-5660
Mailing Address - Fax:253-854-7025
Practice Address - Street 1:1549 GEORGIA AVE
Practice Address - Street 2:
Practice Address - City:RICHLAND
Practice Address - State:WA
Practice Address - Zip Code:99352-4756
Practice Address - Country:US
Practice Address - Phone:509-735-1062
Practice Address - Fax:509-737-8492
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-25
Last Update Date:2019-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist