Provider Demographics
NPI:1902135361
Name:DINESH, BAGYALSKHMI (MSC)
Entity Type:Individual
Prefix:MRS
First Name:BAGYALSKHMI
Middle Name:
Last Name:DINESH
Suffix:
Gender:F
Credentials:MSC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1542 E LAKE SAMMAMISH PKWY NE
Mailing Address - Street 2:
Mailing Address - City:SAMMAMISH
Mailing Address - State:WA
Mailing Address - Zip Code:98074-6639
Mailing Address - Country:US
Mailing Address - Phone:425-868-3669
Mailing Address - Fax:
Practice Address - Street 1:1542 E LAKE SAMMAMISH PKWY NE
Practice Address - Street 2:
Practice Address - City:SAMMAMISH
Practice Address - State:WA
Practice Address - Zip Code:98074-6639
Practice Address - Country:US
Practice Address - Phone:425-868-3669
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-14
Last Update Date:2009-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALL 00003898235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist