NPI 1669287579 · live from the CMS NPI Registry
Ivanisse Coraly Asencio-Acevedo, M.S. CCC-SLP
Speech-Language Pathologist, in Tacoma, WA. National Provider Identifier 1669287579, active.
NPI record
| NPI | 1669287579 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Speech-Language Pathologist, 235Z00000X |
| Practice location | 1502 S Orchard St Apt F304, Tacoma, WA 98465 |
| Practice phone | 334-470-6604 |
| Enumerated | February 8, 2025 |
| Last updated | February 18, 2025 |
| Sole proprietor | Yes |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Speech-Language Pathologist, primary | 235Z00000X | LL60846550 (WA) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.