Provider Demographics
NPI:1174998496
Name:MCCARRON, CAITLIN MAIRE (CCC-SLP)
Entity type:Individual
Prefix:
First Name:CAITLIN
Middle Name:MAIRE
Last Name:MCCARRON
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1425 COWGILL AVE
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98225-8016
Mailing Address - Country:US
Mailing Address - Phone:207-317-7604
Mailing Address - Fax:
Practice Address - Street 1:2726 ALDERWOOD AVE
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-1223
Practice Address - Country:US
Practice Address - Phone:360-733-2322
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-12-11
Last Update Date:2015-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WASI60541872235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist