Individual
JENNIFER GILLINGS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S., CCC-SLP
Contact information
Practice address
17418 74TH AVE E, PUYALLUP, WA 98375
(253) 683-6361
Mailing address
17418 74TH AVE E, PUYALLUP, WA 98375
(253) 677-0265
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
LL60244325
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7441157
—
WA
Enumeration date
11/05/2012
Last updated
11/07/2012
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