Abawag, Jessica Fairbanks
Abawag, Jessica Fairbanks is an individual health care provider with primary practice located at 2601 70Th Ave W Ste E , University Place WA 98466-5430. She recently has only one registered license in Speech, Language and Hearing Service Providers / Speech-Language Pathologist, which is considered as her primary health care specialty. Abawag, Jessica Fairbanks can be contacted via phone (253) 212-3502.Contact Information
Primary practice address
2601 70Th Ave W Ste E
University Place WA 98466-5430
Phone: (253) 212-3502
Fax: (888) 972-1827
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Speech, Language and Hearing Service Providers / Speech-Language Pathologist | 235Z00000X | 20826 | California |
| Speech, Language and Hearing Service Providers / Speech-Language Pathologist | 235Z00000X | LL60654675 | Washington |
Profile Details
| NPI number | 1225392392 |
|---|---|
| LBN Legal business name | Abawag, Jessica Fairbanks |
| Credentials | CCC-SLP |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 3rd, 2012 |
| Last updated | Feb 8th, 2023 - about last year |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1225392392 | NPPES |
| Washington | MEDICAID | 2069268 |
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