| NPI | 1871037184 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICOLE M JONAK Provider/Owner 971-361-6299 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: WA LL-60602511) |
| Enumeration Date | 2016-12-06 |
| Last Update Date | 2016-12-06 |