Provider Demographics
NPI:1699323865
Name:BRITTANY OLSEN-BOBLITT, MS, CCC-SLP, LLC
Entity type:Organization
Organization Name:BRITTANY OLSEN-BOBLITT, MS, CCC-SLP, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SPEECH LANGUAGE PATHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:BRITTANY
Authorized Official - Middle Name:
Authorized Official - Last Name:OLSEN-BOBLITT
Authorized Official - Suffix:
Authorized Official - Credentials:MS, CCC-SLP
Authorized Official - Phone:206-409-6639
Mailing Address - Street 1:6210 WINDFALL RD
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:WA
Mailing Address - Zip Code:98236-8613
Mailing Address - Country:US
Mailing Address - Phone:206-409-6639
Mailing Address - Fax:
Practice Address - Street 1:6210 WINDFALL RD
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:WA
Practice Address - Zip Code:98236-8613
Practice Address - Country:US
Practice Address - Phone:206-409-6639
Practice Address - Fax:360-641-7322
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-29
Last Update Date:2022-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2135360Medicaid