Provider Demographics
NPI:1871074005
Name:THE SPEECH ORCHARD, LLC
Entity type:Organization
Organization Name:THE SPEECH ORCHARD, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HALEY
Authorized Official - Middle Name:
Authorized Official - Last Name:SHADOAN
Authorized Official - Suffix:
Authorized Official - Credentials:MS CCC-SLP
Authorized Official - Phone:206-751-6266
Mailing Address - Street 1:16320 FREMONT PL N
Mailing Address - Street 2:
Mailing Address - City:SHORELINE
Mailing Address - State:WA
Mailing Address - Zip Code:98133-5611
Mailing Address - Country:US
Mailing Address - Phone:206-751-6266
Mailing Address - Fax:
Practice Address - Street 1:23931 HIGHWAY 99 UNIT 103
Practice Address - Street 2:
Practice Address - City:EDMONDS
Practice Address - State:WA
Practice Address - Zip Code:98026-9259
Practice Address - Country:US
Practice Address - Phone:206-751-6266
Practice Address - Fax:206-519-6695
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-25
Last Update Date:2019-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALL60707476261QH0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech