Doctor Name: | SEBASTIAN EDWARD CHARBONNEAU |
NPI Number: | 1396155495 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MS, CCC-SLP |
License Number: | LL60420589 |
Business Practice Address: | 1310 Nw 46th St Vancouver, WA - 986631742 |
Business Phone Number: | 9712429799 |
Business Fax Number: | |
Mailing Address: | 1310 Nw 46th St, VANCOUVER |
State: | WA |
Postal Code: | 986631742 |
Phone Number: | 9712429799 |
Fax Number: | |
NPI Enumeration Date: | 04/29/2014 |
NPI Last Update Date: | 04/29/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | LL60420589 |
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 |