Provider Demographics
NPI:1760127179
Name:GREGOIRE, KAIDEN M
Entity type:Individual
Prefix:
First Name:KAIDEN
Middle Name:M
Last Name:GREGOIRE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:KAIDEN
Other - Middle Name:M
Other - Last Name:GREGOIRE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:5343 TALLMAN AVE NW APT 731
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98107-3942
Mailing Address - Country:US
Mailing Address - Phone:503-490-8347
Mailing Address - Fax:
Practice Address - Street 1:110 S APPLE BLOSSOM DR
Practice Address - Street 2:
Practice Address - City:CHELAN
Practice Address - State:WA
Practice Address - Zip Code:98816-8810
Practice Address - Country:US
Practice Address - Phone:509-682-3300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-29
Last Update Date:2025-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ106S00000X
WA235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician