Provider Demographics
NPI:1447501572
Name:WEBB, MARY CLAIRE (MA, CCC-SLP)
Entity type:Individual
Prefix:MS
First Name:MARY
Middle Name:CLAIRE
Last Name:WEBB
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14330 DENSMORE AVE N
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98133-7134
Mailing Address - Country:US
Mailing Address - Phone:206-364-8704
Mailing Address - Fax:
Practice Address - Street 1:20420 68TH AVE W
Practice Address - Street 2:
Practice Address - City:LYNNWOOD
Practice Address - State:WA
Practice Address - Zip Code:98036-7405
Practice Address - Country:US
Practice Address - Phone:425-431-1146
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-28
Last Update Date:2012-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist