Provider Demographics
NPI:1063758357
Name:LINTON, SARAH JEAN (MA CCC/SLP)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:JEAN
Last Name:LINTON
Suffix:
Gender:F
Credentials:MA CCC/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:409 MARLAND ST SW APT 5A
Mailing Address - Street 2:
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98502-8653
Mailing Address - Country:US
Mailing Address - Phone:360-870-1160
Mailing Address - Fax:
Practice Address - Street 1:1700 PALISADE BLVD
Practice Address - Street 2:
Practice Address - City:DUPONT
Practice Address - State:WA
Practice Address - Zip Code:98327-9734
Practice Address - Country:US
Practice Address - Phone:253-583-7146
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-14
Last Update Date:2012-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALL00004643235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WALL00004643OtherWA STATE LICENSE FOR SPEECH LANGUAGE PATHOLOGIST
12021858OtherAMERICAN SPEECH AND HEARING ASSOCIATION CERTIFICAT OF CLINICAL COMPETENCE