Individual
THERESA SHUCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS CCC-SLP
Contact information
Practice address
1981 NE COLUMBIA RD, SEATTLE, WA 98195-1806
(206) 543-4011
Mailing address
1981 NE COLUMBIA RD, SEATTLE, WA 98195-2231
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
108982
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1639581853
—
TX
Enumeration date
05/22/2014
Last updated
03/01/2018
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