Provider Demographics
NPI:1336351550
Name:POSPISIL, YARROW AMYBETH (MA, CCC)
Entity type:Individual
Prefix:MS
First Name:YARROW
Middle Name:AMYBETH
Last Name:POSPISIL
Suffix:
Gender:F
Credentials:MA, CCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 104
Mailing Address - Street 2:
Mailing Address - City:ACME
Mailing Address - State:WA
Mailing Address - Zip Code:98220
Mailing Address - Country:US
Mailing Address - Phone:360-920-4411
Mailing Address - Fax:
Practice Address - Street 1:1200 HARRIS AVE
Practice Address - Street 2:#306
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225
Practice Address - Country:US
Practice Address - Phone:360-676-8099
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-03
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALL00001973235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA7120827Medicaid