Provider Demographics
NPI:1114643111
Name:KEYES, ANNIE LI (CCC-SLP)
Entity type:Individual
Prefix:
First Name:ANNIE
Middle Name:LI
Last Name:KEYES
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:ANNIE
Other - Middle Name:
Other - Last Name:LI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3322 VIEW POINT CIR NE
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98422-4519
Mailing Address - Country:US
Mailing Address - Phone:949-326-8282
Mailing Address - Fax:
Practice Address - Street 1:2626 SW 327TH ST
Practice Address - Street 2:
Practice Address - City:FEDERAL WAY
Practice Address - State:WA
Practice Address - Zip Code:98023-2535
Practice Address - Country:US
Practice Address - Phone:253-945-3517
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-12
Last Update Date:2022-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA61366751235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist