| Doctor Name: | MARIAH CARMEN KANAKIA |
| NPI Number: | 1154776599 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MS CF-SLP |
| License Number: | SI 60597418 |
| Business Practice Address: | 900 Pacific Ave Ste 130 Everett, WA - 982014188 |
| Business Phone Number: | 4252587352 |
| Business Fax Number: | 4252587618 |
| Mailing Address: | 9742 Ne 119th Way, Apt D218 KIRKLAND |
| State: | WA |
| Postal Code: | 980348945 |
| Phone Number: | 3094537266 |
| Fax Number: | |
| NPI Enumeration Date: | 05/03/2016 |
| NPI Last Update Date: | 05/03/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 390200000X |
| License Number: | SI 60597418 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WA |
| Taxonomy Type: | Student, Health Care |
| Taxonomy Classification: | Student in an Organized Health Care Education/Training Program |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |