Provider Demographics
NPI:1730802257
Name:SMALLTALK SPEECH & LANGUAGE THERAPY, INC
Entity type:Organization
Organization Name:SMALLTALK SPEECH & LANGUAGE THERAPY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/SLP
Authorized Official - Prefix:
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:
Authorized Official - Last Name:TRIEBWASSER
Authorized Official - Suffix:
Authorized Official - Credentials:CCC-SLP
Authorized Official - Phone:425-533-5402
Mailing Address - Street 1:12727 NORTHUP WAY STE 1
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98005-1917
Mailing Address - Country:US
Mailing Address - Phone:425-533-5402
Mailing Address - Fax:425-454-7997
Practice Address - Street 1:12727 NORTHUP WAY STE 1
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98005-1917
Practice Address - Country:US
Practice Address - Phone:425-533-5402
Practice Address - Fax:425-454-7997
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-20
Last Update Date:2022-09-20
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
WA1720295504Medicaid