Organization Active NPI

Vassalo Speech and Language LLC

  • Speech-Language Pathologist
  • Seattle, WA
National Provider Identifier
1003547316
Registry record updated Jul 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
Legal business name
VASSALO SPEECH AND LANGUAGE LLC
Practice address
2300 W Bertona St
Seattle, WA 98199-2326
Phone
(978) 444-0321
NPI assigned
Jun 19, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Tiffany VassaloNPI 1578041554
Title
Speech-Language Pathologist
Phone
(978) 444-0321

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language PathologistGroup: 193400000X SINGLE SPECIALTY GROUP 235Z00000X Primary

Addresses

Primary practice location

2300 W Bertona St
Seattle, WA 98199-2326

Mailing address

2300 W Bertona St
Seattle, WA 98199-2326

Other names 2

  • Vassalo Speech Doing business as
  • Vassalo Speech and Language Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, CA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20220811003952 WA Part B Supplier - Clinic/Group Practice 7911380787 Receives reassigned benefits from 1 practitioner
Practice locations: Seattle, WA
O20250904004832 CA Part B Supplier - Clinic/Group Practice 7911380787 Receives reassigned benefits from 1 practitioner
Practice locations: Vacaville, CA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1655596800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1657843200000",
    "number": "1003547316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2300 W BERTONA ST",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981992326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 W BERTONA ST",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981992326",
            "telephone_number": "978-444-0321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VASSALO SPEECH AND LANGUAGE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-06-19",
        "last_updated": "2022-07-15",
        "certification_date": "2022-07-15",
        "status": "A",
        "authorized_official_last_name": "VASSALO",
        "authorized_official_first_name": "TIFFANY",
        "authorized_official_title_or_position": "SPEECH-LANGUAGE PATHOLOGIST",
        "authorized_official_telephone_number": "978-444-0321"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Vassalo Speech",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Vassalo Speech and Language",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Seattle, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.