Provider Demographics
NPI:1386877140
Name:SHINN ANDERSON, LINDA (MS CCC SLP)
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:
Last Name:SHINN ANDERSON
Suffix:
Gender:F
Credentials:MS CCC SLP
Other - Prefix:
Other - First Name:LINDA
Other - Middle Name:MARIE
Other - Last Name:SHINN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 24269
Mailing Address - Street 2:
Mailing Address - City:FEDERAL WAY
Mailing Address - State:WA
Mailing Address - Zip Code:98093-1269
Mailing Address - Country:US
Mailing Address - Phone:253-874-5445
Mailing Address - Fax:253-874-0687
Practice Address - Street 1:35535 6TH PL SW
Practice Address - Street 2:
Practice Address - City:FEDERAL WAY
Practice Address - State:WA
Practice Address - Zip Code:98023
Practice Address - Country:US
Practice Address - Phone:253-874-5445
Practice Address - Fax:253-874-0687
Is Sole Proprietor?:No
Enumeration Date:2009-08-27
Last Update Date:2009-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALL60103867235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA7136328Medicaid