Provider Demographics
NPI:1932616166
Name:CRUM, RACHEL ELIZABETH (SLP)
Entity type:Individual
Prefix:MISS
First Name:RACHEL
Middle Name:ELIZABETH
Last Name:CRUM
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19105 36TH AVE W STE 206
Mailing Address - Street 2:
Mailing Address - City:LYNNWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98036-5760
Mailing Address - Country:US
Mailing Address - Phone:904-290-3979
Mailing Address - Fax:425-215-0028
Practice Address - Street 1:19105 36TH AVE W STE 206
Practice Address - Street 2:
Practice Address - City:LYNNWOOD
Practice Address - State:WA
Practice Address - Zip Code:98036-5760
Practice Address - Country:US
Practice Address - Phone:904-290-3979
Practice Address - Fax:425-215-0028
Is Sole Proprietor?:No
Enumeration Date:2018-01-09
Last Update Date:2022-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSZ8141235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist