Basic Information
| Provider Information | |||||||||
| NPI: | 1508819368 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SORGE | ||||||||
| FirstName: | ELIZABETH | ||||||||
| MiddleName: | MARGARET | ||||||||
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| Credential: | SLP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 25520 E CENTRAL AVE | ||||||||
| Address2: | |||||||||
| City: | NEWMAN LAKE | ||||||||
| State: | WA | ||||||||
| PostalCode: | 990258614 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5092260546 | ||||||||
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| Practice Location | |||||||||
| Address1: | ST. LUKE'S REHAB | ||||||||
| Address2: | 711 S. COWLEY | ||||||||
| City: | SPOKANE | ||||||||
| State: | WA | ||||||||
| PostalCode: | 99202 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5094736000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/19/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | X | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 235Z00000X | LL00003454 | WA | Y | Speech, Language and Hearing Service Providers | Speech-Language Pathologist |
No ID Information.