Individual
MR. NISANTH PANICKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.S.,CCC-SLP
Contact information
Practice address
920 12TH AVE SE, PUYALLUP, WA 98372-4920
(253) 841-3422
(206) 445-4043
Mailing address
920 12TH AVE SE, PUYALLUP, WA 98372-4920
(253) 841-3422
(206) 445-4043
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
LL00004115
WA
Other
Enumeration date
06/05/2008
Last updated
06/05/2008
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