Active NPI
Peregrine Therapy, PLLC
Doing business as Peregrine Therapy
- Hearing and Speech Clinic/Center
- Redmond, WA
National Provider Identifier
1003688540
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Hearing and Speech Clinic/Center
- Legal business name
- PEREGRINE THERAPY, PLLC
- Doing business as
- Peregrine Therapy
- Practice address
- 16770 NE 79TH St Ste 105
Redmond, WA 98052-4413 - Phone
- (425) 689-8570
- Fax
- (425) 689-7521
- NPI assigned
- Oct 27, 2023
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Daniel Miller IV, MS, MA, CCC-SLP
- Title
- Owner, Speech-Language Pathologist
- Phone
- (765) 476-3108
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | |||
| Hearing and Speech Clinic/Center | 261QH0700X | Primary |
Addresses
Primary practice location
16770 NE 79TH St Ste 105
Redmond, WA 98052-4413
Mailing address
16770 NE 79TH St Ste 105
Redmond, WA 98052-4413
Phone (425) 689-8570
Other names 1
- Peregrine Therapy
National Provider Directory
National Provider DirectoryLocations
16770 NE 79th St
Ste 105
Redmond, WA 98052
Phone (425) 689-8570
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Speech-Language Pathologist
- Redmond, WA
- NPI 1215331764
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1698364800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1698364800000",
"number": "1003688540",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16770 NE 79TH ST STE 105",
"city": "REDMOND",
"state": "WA",
"postal_code": "980524413",
"telephone_number": "425-689-8570",
"fax_number": "425-689-7521"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16770 NE 79TH ST STE 105",
"city": "REDMOND",
"state": "WA",
"postal_code": "980524413",
"telephone_number": "425-689-8570",
"fax_number": "425-689-7521"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PEREGRINE THERAPY, PLLC",
"organizational_subpart": "NO",
"enumeration_date": "2023-10-27",
"last_updated": "2023-10-27",
"certification_date": "2023-10-27",
"status": "A",
"authorized_official_last_name": "MILLER",
"authorized_official_first_name": "DANIEL",
"authorized_official_title_or_position": "OWNER, SPEECH-LANGUAGE PATHOLOGIST",
"authorized_official_telephone_number": "765-476-3108",
"authorized_official_name_prefix": "Mr.",
"authorized_official_name_suffix": "IV",
"authorized_official_credential": "MS, MA, CCC-SLP"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Speech-Language Pathologist",
"state": null,
"license": null,
"primary": false
},
{
"code": "261QH0700X",
"taxonomy_group": "",
"desc": "Clinic/Center, Hearing and Speech",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Peregrine Therapy",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Redmond, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.