Organization
LAKESIDE CENTER FOR AUTISM, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAN STACHELSKI MS CCC-SLP (EXECUTIVE DIRECTOR)
(425) 657-0620
Entity
Organization
Contact information
Practice address
5150 VILLAGE PARK DR SE, BELLEVUE, WA 98006-6652
(425) 657-0620
Mailing address
5150 VILLAGE PARK DR SE, BELLEVUE, WA 98006-6652
(425) 657-0620
(425) 502-8425
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
LL00003914
WA
Other
Enumeration date
01/23/2009
Last updated
01/03/2024
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