Provider Demographics
NPI:1679454573
Name:SNOW, SANDRA (MS CCC-SLP)
Entity type:Individual
Prefix:
First Name:SANDRA
Middle Name:
Last Name:SNOW
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:921 NW 59TH ST
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98107-2851
Mailing Address - Country:US
Mailing Address - Phone:206-909-8287
Mailing Address - Fax:
Practice Address - Street 1:2442 NW MARKET ST # 20
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98107-4137
Practice Address - Country:US
Practice Address - Phone:206-909-8287
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-09
Last Update Date:2025-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALL61483446235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist