Provider Demographics
NPI:1063530640
Name:CONNECTIONS SPEECH AND LANGUAGE PATHOLOGY, LLC
Entity type:Organization
Organization Name:CONNECTIONS SPEECH AND LANGUAGE PATHOLOGY, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:BARTEL
Authorized Official - Suffix:
Authorized Official - Credentials:MS, CCC-SLP
Authorized Official - Phone:360-756-1495
Mailing Address - Street 1:3208 E SUNSET DR
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98226-5707
Mailing Address - Country:US
Mailing Address - Phone:360-756-1495
Mailing Address - Fax:360-756-8868
Practice Address - Street 1:1971 MIDWAY LN
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98226-7682
Practice Address - Country:US
Practice Address - Phone:607-561-4953
Practice Address - Fax:360-756-8868
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-26
Last Update Date:2021-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA602220822235Z00000X
235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA7099963Medicaid