Provider Demographics
NPI:1194930206
Name:KENDALL, MEGAN K (SLP)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:K
Last Name:KENDALL
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3600 LIND AVE SW STE 160
Mailing Address - Street 2:
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98055-4934
Mailing Address - Country:US
Mailing Address - Phone:425-656-4215
Mailing Address - Fax:425-656-5075
Practice Address - Street 1:3600 LIND AVE SW STE 160
Practice Address - Street 2:
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98055-4934
Practice Address - Country:US
Practice Address - Phone:425-656-4215
Practice Address - Fax:425-656-5075
Is Sole Proprietor?:No
Enumeration Date:2007-05-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALL00004319235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist