Individual
MICHELE JORGENSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CCC-SLP
Contact information
Practice address
1310 S UNION AVE STE A100, TACOMA, WA 98405-1907
(253) 383-2423
Mailing address
214 SUMMIT AVE, FIRCREST, WA 98466-7422
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
LL00002660
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8344954
—
WA
Enumeration date
11/17/2006
Last updated
07/08/2007
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