Individual
MARY LYNN THOMPSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
364 S PARK ST, WALLA WALLA, WA 99362-3249
(509) 527-3000
Mailing address
1116 BONSELLA ST, WALLA WALLA, WA 99362-2114
(509) 522-1645
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
LL00001503
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
25507846
—
WA
Enumeration date
08/23/2013
Last updated
08/23/2013
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