Basic Information
| Provider Information | |||||||||
| NPI: | 1942538970 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | WIGHTMAN | ||||||||
| FirstName: | ERIN | ||||||||
| MiddleName: | N | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8620 23RD AVE NE APT A305 | ||||||||
| Address2: | |||||||||
| City: | SEATTLE | ||||||||
| State: | WA | ||||||||
| PostalCode: | 981158311 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2069471108 | ||||||||
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| Practice Location | |||||||||
| Address1: | 725 9TH AVE | ||||||||
| Address2: | |||||||||
| City: | SEATTLE | ||||||||
| State: | WA | ||||||||
| PostalCode: | 981042051 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2064054100 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 12/02/2009 | ||||||||
| LastUpdateDate: | 12/02/2009 | ||||||||
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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 | SI 60122224 | WA | Y | Speech, Language and Hearing Service Providers | Speech-Language Pathologist |
No ID Information.