Basic Information
| Provider Information | |||||||||
| NPI: | 1003151572 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ARMSTRONG | ||||||||
| FirstName: | JESSIE | ||||||||
| MiddleName: | M | ||||||||
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| Credential: | SLP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1805 NW CANYONVIEW DRIVE | ||||||||
| Address2: | |||||||||
| City: | PULLMAN | ||||||||
| State: | WA | ||||||||
| PostalCode: | 99163 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2088747763 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1805 NW CANYONVIEW DRIVE | ||||||||
| Address2: | |||||||||
| City: | PULLMAN | ||||||||
| State: | WA | ||||||||
| PostalCode: | 99163 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2088747763 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 12/10/2012 | ||||||||
| LastUpdateDate: | 12/10/2012 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 235Z00000X | Y | Speech, Language and Hearing Service Providers | Speech-Language Pathologist |
No ID Information.