Organization
BLUE SKY PEDIATRIC SPEECH THERAPY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MYRA TISHKOFF M.S., CCC-SLP (OWNER)
(206) 306-9999
Entity
Organization
Contact information
Practice address
14920 WESTMINSTER WAY N STE 1A, SHORELINE, WA 98133-6445
(206) 306-9999
(206) 306-9997
Mailing address
14920 WESTMINSTER WAY N STE 1A, SHORELINE, WA 98133-6445
(206) 306-9999
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
LL00003279
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1689735904
NPI
WA
Enumeration date
03/27/2012
Last updated
03/27/2012
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