Individual
REVA REISTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CCC-SLP
Contact information
Practice address
909 S 336TH ST STE 100, FEDERAL WAY, WA 98003-7394
(253) 661-5166
Mailing address
909 S 336TH ST STE 100, FEDERAL WAY, WA 98003-7394
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
LL61175597
WA
Other
Enumeration date
06/24/2024
Last updated
06/24/2024
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