Basic Information
| Provider Information | |||||||||
| NPI: | 1013054774 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | WINKLER | ||||||||
| FirstName: | SHEILA | ||||||||
| MiddleName: | J | ||||||||
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| Credential: | SLP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1100 OLIVE WAY MSC M4-PA | ||||||||
| Address2: | |||||||||
| City: | SEATTLE | ||||||||
| State: | WA | ||||||||
| PostalCode: | 981011873 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2065155811 | ||||||||
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| Practice Location | |||||||||
| Address1: | 33501 1ST WAY S | ||||||||
| Address2: | |||||||||
| City: | FEDERAL WAY | ||||||||
| State: | WA | ||||||||
| PostalCode: | 980036208 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2538382400 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 01/31/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 235Z00000X | LL00000949 | WA | Y | Speech, Language and Hearing Service Providers | Speech-Language Pathologist |
ID Information
| ID | Type | State | Issuer | Description | US5881553 | 01 | WA | AETNA SPECIALIST PIN | OTHER | 8387243 | 05 | WA | MEDICAID | WI9773 | 01 | WA | KING COUNTY BLUE SHIELD# | OTHER | 0039572 | 01 | WA | LABOR AND INDUSTRIES # | OTHER | P09817 | 01 | WA | PIERCE CO BLUE SHIELD# | OTHER |