Provider Demographics
NPI:1821896713
Name:SHERWOOD, TRISTA (C-SLPA)
Entity type:Individual
Prefix:
First Name:TRISTA
Middle Name:
Last Name:SHERWOOD
Suffix:
Gender:F
Credentials:C-SLPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:320 PACIFIC PL
Mailing Address - Street 2:
Mailing Address - City:MOUNT VERNON
Mailing Address - State:WA
Mailing Address - Zip Code:98273-5463
Mailing Address - Country:US
Mailing Address - Phone:360-416-7570
Mailing Address - Fax:
Practice Address - Street 1:320 PACIFIC PL
Practice Address - Street 2:
Practice Address - City:MOUNT VERNON
Practice Address - State:WA
Practice Address - Zip Code:98273-5463
Practice Address - Country:US
Practice Address - Phone:360-416-7570
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-05
Last Update Date:2025-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
235Z00000X
WA616399062355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist