Organization Active NPI

Peregrine Therapy, PLLC

Doing business as Peregrine Therapy

  • Hearing and Speech Clinic/Center
  • Redmond, WA
National Provider Identifier
1003688540
Registry record updated Oct 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hearing and Speech Clinic/CenterTaxonomy code 261QH0700X
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

Updated by the provider on Oct 27, 2023

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)CodeLicenseStatePrimary
Speech-Language PathologistGroup: 193400000X SINGLE SPECIALTY GROUP 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 Doing business as

National Provider Directory

National Provider Directory

Locations

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.

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.

Verify at the official NPI Registry.