Provider Demographics
NPI:1801277249
Name:PENCE, ASHA (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:ASHA
Middle Name:
Last Name:PENCE
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:ASHA
Other - Middle Name:
Other - Last Name:TROY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, CCC-SLP
Mailing Address - Street 1:12119 N DAKOTA LN
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99218-3609
Mailing Address - Country:US
Mailing Address - Phone:702-218-9835
Mailing Address - Fax:
Practice Address - Street 1:506 W 2ND AVE
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99201-4302
Practice Address - Country:US
Practice Address - Phone:509-838-2310
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-11
Last Update Date:2023-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALL60575851235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist