Organization
CHILDRENS COMMUNICATION CORNER INC
Active
Other names
Shana Kelly MD CCC-SLP
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SHANA L KELLY MS CCC SLP (OWNER/SLP)
(206) 299-1780
Entity
Organization
Contact information
Practice address
2366 EASTLAKE AVE E, #307, SEATTLE, WA 98102
(206) 371-9133
(206) 524-9836
Mailing address
4115 UNIVERSITY WAY NE,, STE 202, SEATTLE, WA 98105
(206) 299-1780
(206) 524-9836
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
LL00003194
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6704KE
REGENCE BLUE SHIELD OF WA
WA
05
—
7115272
—
WA
Enumeration date
04/07/2006
Last updated
03/02/2015
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