Provider Demographics
NPI:1861895369
Name:JAROSS, JOANNA ELISE (SLP)
Entity type:Individual
Prefix:
First Name:JOANNA
Middle Name:ELISE
Last Name:JAROSS
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1113 A ST STE 202
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98402-5009
Mailing Address - Country:US
Mailing Address - Phone:253-256-2118
Mailing Address - Fax:
Practice Address - Street 1:1113 A ST STE 202
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98402-5009
Practice Address - Country:US
Practice Address - Phone:253-256-2118
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-29
Last Update Date:2018-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALL60361757235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist