Individual
JESSICA FAIRBANKS ABAWAG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CCC-SLP
Contact information
Practice address
2601 70TH AVE W STE E, UNIVERSITY PLACE, WA 98466-5430
(253) 212-3502
(888) 972-1827
Mailing address
2601 70TH AVE W STE E, UNIVERSITY PLACE, WA 98466-5430
(253) 212-3502
(888) 972-1827
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
20826
CA
235Z00000X
Speech-Language Pathologist
Primary
LL60654675
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2069268
—
WA
Enumeration date
07/03/2012
Last updated
02/08/2023
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