Individual
WENDY ELIASON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
2401 BRISTOL CT SW STE D103, OLYMPIA, WA 98502-6037
(360) 357-3339
Mailing address
848 ULERY ST SE, LACEY, WA 98503-1347
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
LL00004215
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LL00004215
LICENSE
WA
Enumeration date
10/05/2015
Last updated
10/05/2015
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