Individual provider Active NPI

Kathrin Leigh Russette, M.A., CCC-SLP

  • Speech-Language Pathologist
  • Spokane Valley, WA
National Provider Identifier
1023624822
Registry record updated Sep 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
LL60316940 Issued in WA
Practice address
2301 S Steen Rd
Spokane Valley, WA 99037-8030
Phone
(855) 633-3627
NPI assigned
Sep 17, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X LL60316940 WA Primary

Addresses

Primary practice location

2301 S Steen Rd
Spokane Valley, WA 99037-8030

Mailing address

10304 Interlake Ave N
Seattle, WA 98133-9414
Phone (425) 890-7462

Other practice location 1

2811 S 102nd St Ste 22
Tukwila, WA 98168-1870
Phone (425) 525-6800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
LL60316940WAMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1600300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600300800000",
    "number": "1023624822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10304 INTERLAKE AVE N",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981339414",
            "telephone_number": "425-890-7462"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2301 S STEEN RD",
            "city": "SPOKANE VALLEY",
            "state": "WA",
            "postal_code": "990378030",
            "telephone_number": "855-633-3627"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2811 S 102nd St Ste 22",
            "address_purpose": "LOCATION",
            "city": "Tukwila",
            "state": "WA",
            "postal_code": "981681870",
            "country_code": "US",
            "telephone_number": "425-525-6800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RUSSETTE",
        "first_name": "KATHRIN",
        "middle_name": "LEIGH",
        "credential": "M.A., CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-17",
        "last_updated": "2020-09-17",
        "certification_date": "2020-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "WA",
            "license": "LL60316940",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Spokane Valley, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2020; 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.