Provider Demographics
NPI:1043050057
Name:WHALEN, CHANDLER JAMES (SLPA)
Entity type:Individual
Prefix:
First Name:CHANDLER
Middle Name:JAMES
Last Name:WHALEN
Suffix:
Gender:M
Credentials:SLPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1080 E BENSON LAKE DR
Mailing Address - Street 2:
Mailing Address - City:GRAPEVIEW
Mailing Address - State:WA
Mailing Address - Zip Code:98546-8923
Mailing Address - Country:US
Mailing Address - Phone:235-355-1642
Mailing Address - Fax:
Practice Address - Street 1:22900 WA-3
Practice Address - Street 2:
Practice Address - City:BELFAIR
Practice Address - State:WA
Practice Address - Zip Code:98528
Practice Address - Country:US
Practice Address - Phone:360-277-2233
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-28
Last Update Date:2024-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WASP615002562355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant