Individual
JEEWON KELLY SON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, CCC-SLP
Contact information
Practice address
3119 HANNA DR NE, LACEY, WA 98516-7169
(562) 544-8032
Mailing address
3119 HANNA DR NE, LACEY, WA 98516-7169
(562) 544-8032
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
61141790
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
61141790
CCC-SLP
WA
Enumeration date
12/21/2021
Last updated
08/26/2025
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