Individual
MRS. JACQUELINE ELIZABETH GROSSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, CCC
Contact information
Practice address
7981 168TH AVE NE STE 122, REDMOND, WA 98052-0911
(831) 588-2899
Mailing address
15585 NE 68TH CT, REDMOND, WA 98052-4829
(831) 588-2899
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
12851
NC
235Z00000X
Speech-Language Pathologist
Primary
LL00003852
WA
Other
Enumeration date
10/19/2006
Last updated
07/15/2019
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