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Individual

KELLI J KOEHNEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.S. CCC-SLP

Contact information

Practice address
34920 ENCHANTED PKWY S, FEDERAL WAY, WA 98003
(253) 838-5878
Mailing address
34920 ENCHANTED PKWY S, FEDERAL WAY, WA 98003-8325
(253) 838-5878

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
2712154
WI
235Z00000X
Speech-Language Pathologist
Primary
60383367
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
42571000
WI
Enumeration date
05/25/2007
Last updated
06/12/2019
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