Provider Demographics
NPI:1194125229
Name:GUISTI, TAWNI (CCC SLP)
Entity type:Individual
Prefix:
First Name:TAWNI
Middle Name:
Last Name:GUISTI
Suffix:
Gender:F
Credentials:CCC SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3040 17TH AVE W APT 505
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98119-2278
Mailing Address - Country:US
Mailing Address - Phone:406-214-6719
Mailing Address - Fax:
Practice Address - Street 1:3040 17TH AVE W APT 505
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98119-2278
Practice Address - Country:US
Practice Address - Phone:406-214-6719
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-26
Last Update Date:2014-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALL 60509341235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist