Provider Demographics
NPI:1366570814
Name:SOMAN, ANAGHA VIVEK (CFYSLP)
Entity type:Individual
Prefix:
First Name:ANAGHA
Middle Name:VIVEK
Last Name:SOMAN
Suffix:
Gender:F
Credentials:CFYSLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6507 214TH AVE NE
Mailing Address - Street 2:
Mailing Address - City:REDMOND
Mailing Address - State:WA
Mailing Address - Zip Code:98053-2311
Mailing Address - Country:US
Mailing Address - Phone:425-868-7774
Mailing Address - Fax:425-513-0917
Practice Address - Street 1:14 E CASINO RD
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98208-2628
Practice Address - Country:US
Practice Address - Phone:425-523-1663
Practice Address - Fax:425-513-0917
Is Sole Proprietor?:No
Enumeration Date:2007-02-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WASI00004179235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist