Provider Demographics
NPI:1427446020
Name:GIANNINI, EBOLI
Entity type:Individual
Prefix:
First Name:EBOLI
Middle Name:
Last Name:GIANNINI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12537 42ND AVE NE
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98125-4620
Mailing Address - Country:US
Mailing Address - Phone:206-816-2711
Mailing Address - Fax:
Practice Address - Street 1:1959 NE PACIFIC ST
Practice Address - Street 2:BOX 356154
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98195-6154
Practice Address - Country:US
Practice Address - Phone:206-816-2711
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-01-05
Last Update Date:2015-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALL60072911235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist