Mary L Dahlstrom, CCC - SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

LL00004482 Issued in WA

Practice address

126 Awesome Dr
Chehalis, WA 98532-9075

Phone

(360) 357-3339

NPI assigned

Jun 9, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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": "1181347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1841493442",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "126 AWESOME DR",
            "city": "CHEHALIS",
            "state": "WA",
            "postal_code": "985329075",
            "telephone_number": "360-748-8065",
            "fax_number": "360-748-1163"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "126 AWESOME DR",
            "city": "CHEHALIS",
            "state": "WA",
            "postal_code": "985329075",
            "telephone_number": "360-357-3339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAHLSTROM",
        "first_name": "MARY",
        "middle_name": "L",
        "credential": "CCC - SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-06-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "WA",
            "license": "LL00004482",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James Robert Cozadd, CP 60390166
• Laurie Jane Crivello
• Elizabeth A Cumberland, MSN, RN, DIPACLM
• Isabella Curwood, LMT
• Marceline Elaine Daarud
• Cara Rae Dalrymple, RN
• Elsa S Daly, PEER SPECIALIST
• Daniela Margarethe Dandridge, PHARM.D.
• Robert Dandy
• Daniel M. Henricksen DDS Ms PLLC

• Speech-Language Pathologist in Chehalis, WA
• Providers in Chehalis, WA by specialty
• Speech-Language Pathologist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.