NPI 1124287891 · live from the CMS NPI Registry
Jessica Banashak, M.A.CCC-SLP
Speech-Language Pathologist, in Seattle, WA. National Provider Identifier 1124287891, active.
NPI record
| NPI | 1124287891 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Speech-Language Pathologist, 235Z00000X |
| Practice location | 7125 Fauntleroy Way Sw, Seattle, WA 98136 |
| Practice phone | 206-937-2800 |
| Mailing address | 4560 Se International Way, Suite 100, Milwaukie, OR 97222 |
| Enumerated | June 6, 2008 |
| Last updated | March 17, 2011 |
| Sole proprietor | Yes |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Speech-Language Pathologist, primary | 235Z00000X | LL60016404 (WA) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.