Amanda Pawlak, C-SLPA

Primary specialty

Speech-Language AssistantTaxonomy code 2355S0801X

License

SP61599543 Issued in WA

Practice address

205 N Alder Ave
Granite Falls, WA 98252-8907

Phone

(360) 691-7717

NPI assigned

Sep 27, 2024

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Amanda Gruber Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1727395200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727395200000",
    "number": "1750109880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10410 TAILSPAR AVE",
            "city": "GRANITE FALLS",
            "state": "WA",
            "postal_code": "982529070",
            "telephone_number": "425-923-4487"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 N ALDER AVE",
            "city": "GRANITE FALLS",
            "state": "WA",
            "postal_code": "982528907",
            "telephone_number": "360-691-7717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAWLAK",
        "first_name": "AMANDA",
        "credential": "C-SLPA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-09-27",
        "last_updated": "2024-09-27",
        "certification_date": "2024-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2355S0801X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Speech-Language Assistant",
            "state": "WA",
            "license": "SP61599543",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMANDA",
            "last_name": "GRUBER",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Speech-Language Assistant in Granite Falls, WA
• Providers in Granite Falls, WA by specialty
• Speech-Language Assistant in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.