Individual
LORETTA WALSH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
11104 NE 149TH ST, BRUSH PRAIRIE, WA 98606-9565
(360) 885-5318
Mailing address
PO BOX 200, BATTLE GROUND, WA 98604-0200
(360) 885-5300
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
LL60202421
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01123060
AMERICAN SPEECH-LANGUAGE-HEARING ASSOCIATION
—
01
—
LL60202421
STATE SLP LICENSURE
WA
Enumeration date
10/26/2012
Last updated
10/26/2012
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