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Individual

ETHAN WASH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
2655 N PEBBLE CREEK PKWY, GOODYEAR, AZ 85395-9051
(602) 677-8992
(602) 677-8992
Mailing address
9164 W SANDRA TER, PEORIA, AZ 85382-3560

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
14069277
AZ

Other

Enumeration date
05/30/2017
Last updated
05/30/2017
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