Kara Renee Gamboa, MS CCC - SLP

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

NPI 1801148606 · NPPES record last updated Oct 4, 2012

Key facts

NPI
1801148606
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
12027111 (WA)
Practice address
1100 34TH St.
Washougal, WA 98671
Phone
(360) 954-3775
Fax
(360) 954-3799
NPI assigned
Oct 4, 2012
Sex
Female
Sole proprietor
No

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

LicenseStateTypeSpecialty
12027111WAMDSpeech-Language Pathologist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 12027111 WA Yes

Addresses

Primary practice location

1100 34TH St.
Washougal, WA 98671

Mailing address

1100 34TH St.
Washougal, WA 98671
Phone (360) 954-3775

Other names

  • Ms. Kara Renee Haven Former name

Other providers in Washougal, WA

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

Sources for this page

Verify at the official NPI Registry.