Individual
MISS KELLEY ANN FORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, CCC-SLP
Contact information
Practice address
19401 40TH AVE W, SUITE 310, LYNNWOOD, WA 98036-4612
(425) 582-2473
(425) 582-2475
Mailing address
19401 40TH AVE W, SUITE 310, LYNNWOOD, WA 98036-4612
(425) 582-2473
(425) 582-2475
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
LL00003769
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12042972
ASHA NUMBER
WA
01
—
4230FO
REGENCE LYNNWOOD NUMBER
WA
05
—
7028319
—
WA
01
—
7552818
AETNA INS. CO. NUMBER
WA
05
—
8412520
—
WA
Enumeration date
11/28/2006
Last updated
02/11/2008
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