Dora G Gutierrez, SLPA, AA
Individual provider Active NPI Speech-Language Assistant · Connell, WA
NPI 1245577360 · NPPES record last updated Jan 9, 2013
Key facts
- NPI
- 1245577360
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Assistant 2355S0801X
- License
- SP 6021648 (WA)
- Practice address
- 1100 W. Clark Rd Box 829
Connell, WA 99326-0829 - Phone
- (509) 234-9218
- Fax
- (509) 234-9204
- NPI assigned
- Jan 9, 2013
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Associate of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SP 6021648 | WA | MD | Speech-Language Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| North Franklin School District | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Assistant | 2355S0801X | SP 6021648 | WA | Yes |
Addresses
Primary practice location
1100 W. Clark Rd Box 829
Connell, WA 99326-0829
Mailing address
1100 W. Clark Rd
PO Box 829
Connell, WA 99326-0829
Phone (509) 234-9218
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| SLPA SP60219648 | Other | WA | SPEECH LANGUAGE PATHOLOGY ASSISTANT CERTIFACATION |
Other providers in Connell, WA
- Raeann Marie Fleming
- Gary Byron Fletcher
- Jessica Lynn Forsyth
- Linda Gimmeson
- Gwyn Renee Gregg
- Timothy Michael Hall
- Tony A Harrington
- Chelsie Anne Henden
- Helen Elizabeth Jack
- Jaeniffer Ang Kaiser
All providers in Connell, WA · Speech-Language Assistant in Washington
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 9, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.