Basic Information
| Provider Information | |||||||||
| NPI: | 1033648357 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BUDKE | ||||||||
| FirstName: | ELIZABETH | ||||||||
| MiddleName: | GRAHAM | ||||||||
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| Credential: | CCC-SLP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 337 W 14TH AVE | ||||||||
| Address2: | |||||||||
| City: | SPOKANE | ||||||||
| State: | WA | ||||||||
| PostalCode: | 992043617 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 15098473373 | ||||||||
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| Practice Location | |||||||||
| Address1: | 7411 N NEVADA ST | ||||||||
| Address2: | |||||||||
| City: | SPOKANE | ||||||||
| State: | WA | ||||||||
| PostalCode: | 992085518 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5094892273 | ||||||||
| FaxNumber: | 5094823041 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/09/2017 | ||||||||
| LastUpdateDate: | 06/09/2017 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 235Z00000X | LL60753272 | WA | Y | Speech, Language and Hearing Service Providers | Speech-Language Pathologist |
No ID Information.