Provider Demographics
NPI:1194066431
Name:POPA, WENDY JOY (MS SLP CCC)
Entity type:Individual
Prefix:MRS
First Name:WENDY
Middle Name:JOY
Last Name:POPA
Suffix:
Gender:F
Credentials:MS SLP CCC
Other - Prefix:
Other - First Name:WENDY
Other - Middle Name:JOY
Other - Last Name:REPH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:11615 W HUNT RD
Mailing Address - Street 2:
Mailing Address - City:CHENEY
Mailing Address - State:WA
Mailing Address - Zip Code:99004-9627
Mailing Address - Country:US
Mailing Address - Phone:509-434-6704
Mailing Address - Fax:
Practice Address - Street 1:528 E SPOKANE FALLS BLVD STE 502
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99202-5082
Practice Address - Country:US
Practice Address - Phone:509-465-1252
Practice Address - Fax:509-465-1235
Is Sole Proprietor?:No
Enumeration Date:2013-03-12
Last Update Date:2022-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALL 60284080235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WALL60284080OtherWA STATE LICENSE