Provider Demographics
NPI:1699246710
Name:BANKEY, JESSICA ZOE (MA,CCC-SLP)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:ZOE
Last Name:BANKEY
Suffix:
Gender:F
Credentials:MA,CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12824 W 12TH AVE
Mailing Address - Street 2:
Mailing Address - City:AIRWAY HEIGHTS
Mailing Address - State:WA
Mailing Address - Zip Code:99001-9408
Mailing Address - Country:US
Mailing Address - Phone:509-559-4631
Mailing Address - Fax:509-244-0906
Practice Address - Street 1:12824 W 12TH AVE
Practice Address - Street 2:
Practice Address - City:AIRWAY HEIGHTS
Practice Address - State:WA
Practice Address - Zip Code:99001-9408
Practice Address - Country:US
Practice Address - Phone:509-559-4600
Practice Address - Fax:509-244-0906
Is Sole Proprietor?:No
Enumeration Date:2018-12-16
Last Update Date:2018-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60087728235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist