| Organization Name: | LAKESIDE SPEECH LANGUAGE AND LEARNING, LLC |
| NPI Number: | 1265553382 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | DANIEL JAMES STACHELSKI (OWNER/OPERATOR) |
| Mailing Address: | 7829 Center Blvd Ste 223 Snoqualmie |
| State: | WA US |
| Postal Code: | 98065 |
| Phone Number: | 3603039130 |
| Fax Number: | 2063330031 |
| NPI Enumeration Date: | 04/03/2007 |
| NPI Last Update Date: | 08/26/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | LL00003914 |
| 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 |