Individual
HAYLEY J NYSTROM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
8301 161ST AVE NE STE 208, REDMOND, WA 98052-3858
(425) 882-4347
Mailing address
8301 161ST AVE NE STE 208, REDMOND, WA 98052-3858
(425) 882-4347
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
LL61192999
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LL61192999
STATE LICENNSE
WA
Enumeration date
07/10/2021
Last updated
07/10/2021
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