Basic Information
Provider Information
NPI: 1871628156
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SEIGER
FirstName: AMY
MiddleName: LEIGH ANNE
NamePrefix: MRS.
NameSuffix:  
Credential: MS CCC SLP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: PETERS
OtherFirstName: AMY
OtherMiddleName: LEIGH ANNE
OtherNamePrefix: MISS
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType: 1
Mailing Information
Address1: 1963 YAJOME ST
Address2:  
City: NAPA
State: CA
PostalCode: 94558
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 4560 SE INTERNATIONAL WAY
Address2: SUITE 100 CONSONUS HEALTHCARE SERVICES
City: MILWAUKIE
State: OR
PostalCode: 97222
CountryCode: US
TelephoneNumber: 9712065129
FaxNumber: 9712065209
Other Information
ProviderEnumerationDate: 02/23/2007
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
235Z00000X3057OKY Speech, Language and Hearing Service ProvidersSpeech-Language Pathologist 

No ID Information.


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