Taxonomy Codes
The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:
| No. |
Taxonomy Code |
Taxonomy Clasification |
Taxonomy Specialization |
License Number |
License State |
Primary |
| 1 | 235Z00000X | Speech-Language Pathologist | | SI00004391 | WASHINGTON | Yes |
Other Identifiers
The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.
| No. |
Other Provider Identifier |
Other Provider Identifier Type |
Other Provider Identifier State |
Other Provider Identifier Issuer |
| 1 | ========= | OTHER | WASHINGTON | UNIFORM MEDICAL PROVIDER |
| 2 | =========-98103-A006 | OTHER | WASHINGTON | REGENCE TRICARE OT |
| 3 | ========= | OTHER | WASHINGTON | UNITED HEALTHCARE |
| 4 | =========-3670HU | OTHER | WASHINGTON | REGENCE OT |
| 5 | =========-0261VA | OTHER | WASHINGTON | REGENCE OT |
| 6 | ========= | OTHER | WASHINGTON | FIRST CHOICE PPO NET |
| 7 | ========= | OTHER | WASHINGTON | MOLINA HEALTHCARE PROVIDE |
| 8 | =========-8519CO | OTHER | WASHINGTON | REGENCE SPEECH THERAPY |
| 9 | ========= | OTHER | WASHINGTON | PREMERA BLUE CROSS |
| 10 | =========-3671WY | OTHER | WASHINGTON | REGENCE SPEECH THERAPY |
| 11 | 7070949-8347395 | MEDICAID | WASHINGTON | |
| 12 | 7368087 | OTHER | WASHINGTON | AETNA CLINIC NUMBER |
| 13 | 7681083-8415291 | MEDICAID | WASHINGTON | |
| 14 | ========= | OTHER | WASHINGTON | CIGNA PROVIDER NUMBER |
| 15 | 55-0174569 | OTHER | WASHINGTON | LABOR AND INDUSTRIES |
| 16 | 7070949-8347429 | MEDICAID | WASHINGTON | |
| 17 | 397572001 | OTHER | WASHINGTON | GROUP HEALTH PROVIDER NUM |
| 18 | 7681083-8464992 | MEDICAID | WASHINGTON | |
| 19 | =========-0563FA | OTHER | VIRGINIA | REGENCE SPEECH THERAPY |
