Mallory Belanger, MS, CCC-SLP/L
Individual provider Active NPI Speech-Language Pathologist · Port Angeles, WA
NPI 1376996553 · NPPES record last updated Sep 6, 2024
Key facts
- NPI
- 1376996553
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- License
- LL61540437 (WA)
- Practice address
- 905 W 9TH St
Port Angeles, WA 98363-7275 - Phone
- (360) 457-8575
- Fax
- (360) 457-0795
- NPI assigned
- Jul 22, 2016
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LL61540437 | WA | MD | Speech-Language Pathologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | LL61540437 | WA | Yes |
Addresses
Primary practice location
905 W 9TH St
Port Angeles, WA 98363-7275
Mailing address
905 W 9TH St
Port Angeles, WA 98363-7275
Phone (360) 457-8575
Other providers in Port Angeles, WA
- Anthony H. J Becher IV
- Miranda Lee Beck
- Candace Becker
- Heidi Ann Becker
- Emeri Jimenez Beeler
- Amy Bell
- Grace Bell
- Patricia Lisa Bell
- Julie Belling
- Teresa Lynette Benford
All providers in Port Angeles, WA · Speech-Language Pathologist in Washington
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 6, 2024. 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.