Individual
MRS. KELLY MARIE CARLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CCC-SLP
Contact information
Practice address
17535 15TH AVE NE, SHORELINE, WA 98155-3801
(206) 440-9708
(206) 260-2414
Mailing address
11408 33RD ST NE, LAKE STEVENS, WA 98258-8789
(425) 971-0730
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
LL00004054
WA
Other
Enumeration date
12/14/2006
Last updated
07/08/2007
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