Provider Demographics
NPI:1114294857
Name:DAMBOISE, ALISON LESLIE (SLP-CCC)
Entity type:Individual
Prefix:MRS
First Name:ALISON
Middle Name:LESLIE
Last Name:DAMBOISE
Suffix:
Gender:F
Credentials:SLP-CCC
Other - Prefix:MRS
Other - First Name:ALISON
Other - Middle Name:LESLIE
Other - Last Name:DAMBOISE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MS, CCC-SLP
Mailing Address - Street 1:1709 124TH AVE NE UNIT 997
Mailing Address - Street 2:
Mailing Address - City:LAKE STEVENS
Mailing Address - State:WA
Mailing Address - Zip Code:98258-1839
Mailing Address - Country:US
Mailing Address - Phone:360-592-3601
Mailing Address - Fax:425-315-7137
Practice Address - Street 1:1709 124TH AVE NE UNIT 997
Practice Address - Street 2:
Practice Address - City:LAKE STEVENS
Practice Address - State:WA
Practice Address - Zip Code:98258-1839
Practice Address - Country:US
Practice Address - Phone:360-592-3601
Practice Address - Fax:425-315-7137
Is Sole Proprietor?:No
Enumeration Date:2011-11-23
Last Update Date:2024-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALL60171480235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist