Basic Information
| Provider Information | |||||||||
| NPI: | 1205154432 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SAUTER | ||||||||
| FirstName: | RICHARD | ||||||||
| MiddleName: | ALFRED | ||||||||
| NamePrefix: | MR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | LIC SPEECH PATH | ||||||||
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| Mailing Information | |||||||||
| Address1: | 16241 WASHOUGAL RIVER RD | ||||||||
| Address2: | |||||||||
| City: | WASHOUGAL | ||||||||
| State: | WA | ||||||||
| PostalCode: | 986717119 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3608378109 | ||||||||
| FaxNumber: | 3606969517 | ||||||||
| Practice Location | |||||||||
| Address1: | 3506 MAIN ST | ||||||||
| Address2: | |||||||||
| City: | VANCOUVER | ||||||||
| State: | WA | ||||||||
| PostalCode: | 986632224 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3608378109 | ||||||||
| FaxNumber: | 3606969517 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/12/2010 | ||||||||
| LastUpdateDate: | 05/12/2010 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 235Z00000X | LL00001111 | WA | Y | Speech, Language and Hearing Service Providers | Speech-Language Pathologist |
No ID Information.