Individual
MRS. MARY ELLEN TALLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSPA CCC-SLP
Contact information
Practice address
2445 3RD AVE S, SEATTLE, WA 98134-1923
(206) 252-1021
Mailing address
2445 3RD AVE S, SEATTLE, WA 98134-1923
(206) 252-1021
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
LL 00003081
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
LL 00003081
—
WA
Enumeration date
01/29/2013
Last updated
01/29/2013
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