| Evergreen Speech And Hearing Clinic, Inc | |
|
8301 161st Ave Ne #203 Redmond WA 98052-3858 | |
| (425) 882-4347 | |
| (425) 883-0043 |
| Full Name | Evergreen Speech And Hearing Clinic, Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 8301 161st Ave Ne, Redmond, Washington |
| Authorized Official Name and Position | Ruth E Norwood (CLINIC DIRECTOR) |
| Authorized Official Contact | 4258824347 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Evergreen Speech And Hearing Clinic, Inc 8301 161st Ave Ne #203 Redmond WA 98052-3858 Ph: (425) 882-4347 | Evergreen Speech And Hearing Clinic, Inc 8301 161st Ave Ne #203 Redmond WA 98052-3858 Ph: (425) 882-4347 |
| NPI Number | 1346474731 |
|---|---|
| Provider Enumeration Date | 05/13/2009 |
| Last Update Date | 05/13/2009 |
| Medicare PECOS PAC ID | 0840429718 |
|---|---|
| Medicare Enrollment ID | O20140219000759 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346474731 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| Provider Name | Maryam Sadrzadeh |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1164454393 PECOS PAC ID: 4880823756 Enrollment ID: I20140220001766 |
| Provider Name | Jessica Lasser |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1689083123 PECOS PAC ID: 5799907911 Enrollment ID: I20141103002502 |
| Provider Name | Jennifer L Dierenfeld |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1568628907 PECOS PAC ID: 8921220864 Enrollment ID: I20141110001938 |
| Provider Name | Bridget N Griffin |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1346797933 PECOS PAC ID: 8527313923 Enrollment ID: I20180625003582 |
| Provider Name | Maivy Ho |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1013402627 PECOS PAC ID: 1456608520 Enrollment ID: I20180719003308 |
| Provider Name | Hayley Nystrom |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1871165837 PECOS PAC ID: 5698153112 Enrollment ID: I20220610002520 |
| Provider Name | Jeanne Gallee |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1972257400 PECOS PAC ID: 4587045679 Enrollment ID: I20220720003456 |
| Provider Name | Alyssa Peterson |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1659016897 PECOS PAC ID: 2769865021 Enrollment ID: I20220818002651 |
| Provider Name | Kourtney L Soderholm |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1649997230 PECOS PAC ID: 4587029848 Enrollment ID: I20230420002654 |
| Provider Name | Rasena L Wager |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1326765900 PECOS PAC ID: 1052776291 Enrollment ID: I20230424000875 |
| Provider Name | Sydney Miller |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1942980180 PECOS PAC ID: 9436506847 Enrollment ID: I20231107001482 |
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