Gwyn Renee Gregg, SLPA

Individual provider Active NPI Speech-Language Assistant · Connell, WA

NPI 1639416779 · NPPES record last updated Jan 9, 2013

Key facts

NPI
1639416779
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Assistant 2355S0801X
License
SP60219690 (WA)
Practice address
1100 W Clark Rd # 829
Connell, WA 99326-9700
Phone
(509) 234-9218
NPI assigned
Jan 9, 2013
Sex
Female
Sole proprietor
Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
SP60219690WAMDSpeech-Language Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
North Franklin School District Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Assistant 2355S0801X SP60219690 WA Yes

Addresses

Primary practice location

1100 W Clark Rd # 829
Connell, WA 99326-9700

Mailing address

PO Box 829
Connell, WA 99326-0829
Phone (509) 234-9218

Other identifiers

IdentifierTypeStateIssuer
SP 60219690OtherWASPEECH LANG. PATHOLIST ASSISTANT CERTIFICATION

Other providers in Connell, WA

All providers in Connell, WA · Speech-Language Assistant in Washington

Sources for this page

Verify at the official NPI Registry.