Ruth Ann Hackenbracht, SLP

Individual provider Active NPI Speech-Language Pathologist · Sultan, WA

NPI 1770547283 · NPPES record last updated Dec 2, 2021

Key facts

NPI
1770547283
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
LL00002761 (WA)
Practice address
13507 327TH CT SE
Sultan, WA 98294-8722
Phone
(425) 890-5148
Fax
(425) 654-0562
NPI assigned
Apr 12, 2006
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

State licenses

LicenseStateTypeSpecialty
LL00002761WAMDSpeech-Language Pathologist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X LL00002761 WA Yes

Addresses

Primary practice location

13507 327TH CT SE
Sultan, WA 98294-8722

Mailing address

PO Box 400
Puyallup, WA 98371-8901
Phone (360) 794-1061

Other providers in Sultan, WA

All providers in Sultan, WA · Speech-Language Pathologist in Washington

Sources for this page

Verify at the official NPI Registry.