Doctor Name: | MS. RANDI MELIA MAYON |
NPI Number: | 1174748867 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MA, CCC-SLP |
License Number: | LL00003073 |
Business Practice Address: | 1407 Boalch Ave Nw North Bend, WA - 980457994 |
Business Phone Number: | 4258882777 |
Business Fax Number: | 4258882010 |
Mailing Address: | 2454 33rd Ave Ne, ISSAQUAH |
State: | WA |
Postal Code: | 980293601 |
Phone Number: | 4257937153 |
Fax Number: | |
NPI Enumeration Date: | 04/16/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | LL00003073 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WA |
Taxonomy Type: | Speech, Language and Hearing Service Providers |
Taxonomy Classification: | Speech-Language Pathologist |
Taxonomy Specialization: | |
Taxonomy Definition: | A speech pathologist is a person qualified by a master |