Individual
REBECCA WYNNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S. CCC-SLP
Contact information
Practice address
1508 136TH STREET SOUTHEAST, HENRY M. JACKSON HIGH SCHOOL, MILLCREEK, WA 98208-8004
(425) 385-7000
Mailing address
4703 COLBY AVENUE, EVERETT, WA 98203
(425) 385-5250
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SI00004391
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12151528
CCC
WA
Enumeration date
11/21/2006
Last updated
12/19/2012
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