1689877722 NPI number — CHRISTIANE DECHERT M.A., CCC-SLP

Table of content: CHRISTIANE DECHERT M.A., CCC-SLP (NPI 1689877722)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1689877722 NPI number — CHRISTIANE DECHERT M.A., CCC-SLP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
DECHERT
Provider First Name:
CHRISTIANE
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.A., CCC-SLP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1689877722
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/27/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
310 N RIVERPOINT BLVD STE V
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SPOKANE
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
99202-0002
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
509-828-1324
Provider Business Mailing Address Fax Number:
509-368-6890

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
310 N RIVERPOINT BLVD STE V
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SPOKANE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
99202-0002
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
307-766-6438
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/07/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 235Z00000X , with the licence number:  SLP 293 , registered in the state of WY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: SLP 293 . This is a "SPEECH-LANGUAGE PATHOLOGY" identifier , issued by the state of ( WY ) . This identifiers is of the category "OTHER".




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