Provider Demographics
NPI:1912557778
Name:MCCAULEY, PAMELA (SLPA CERTIFICATION)
Entity type:Individual
Prefix:
First Name:PAMELA
Middle Name:
Last Name:MCCAULEY
Suffix:
Gender:F
Credentials:SLPA CERTIFICATION
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1107 N J ST
Mailing Address - Street 2:
Mailing Address - City:ABERDEEN
Mailing Address - State:WA
Mailing Address - Zip Code:98520-2437
Mailing Address - Country:US
Mailing Address - Phone:360-580-2246
Mailing Address - Fax:
Practice Address - Street 1:1313 PACIFIC AVE
Practice Address - Street 2:
Practice Address - City:ABERDEEN
Practice Address - State:WA
Practice Address - Zip Code:98520-4700
Practice Address - Country:US
Practice Address - Phone:360-538-2190
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-13
Last Update Date:2019-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WASP608622532355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant