Organization
KELLEY A. FORD, MS, CCC-SLP, PS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. KELLEY A FORD M.S., CCC-SLP (OWNER)
(206) 954-1012
Entity
Organization
Contact information
Practice address
19401 40TH AVE W, SUITE 310, LYNNWOOD, WA 98036-4612
(425) 582-2473
(425) 582-2475
Mailing address
19401 40TH AVE W, SUITE 310, LYNNWOOD, WA 98036-4612
(425) 582-2473
(425) 582-2475
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
LL00003769
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7140858
—
WA
Enumeration date
07/28/2010
Last updated
07/28/2010
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