Form Speech and Swallowing PLLC

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

Legal business name

FORM SPEECH AND SWALLOWING PLLC

Practice address

100 N Howard St. Ste R
Spokane, WA 99201

Phone

(608) 352-0650

NPI assigned

Oct 8, 2025

Organization subpart

No

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

Authorized official

Name

Gloria LeeNPI 1053208702

Title

Speech-Language Pathologist

Phone

(608) 352-0650

Specialties & licenses 1

Addresses

Practitioners 2

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.

• Gloria Lee

  • Speech-Language Pathologist
  • Seattle, WA
  • NPI 1053208702
  NPD Authorized official
• Corinne Jarvis, M.S., CCC-SLP

  • Speech-Language Pathologist
  • Lake Oswego, OR
  • NPI 1306099460
  NPD

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

{
    "created_epoch": "1759881600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1759881600000",
    "number": "1053286120",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12819 SE 38TH ST # 255",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980061326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 N HOWARD ST. STE R",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "99201",
            "telephone_number": "608-352-0650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FORM SPEECH AND SWALLOWING PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-10-08",
        "last_updated": "2025-10-08",
        "certification_date": "2025-09-22",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "GLORIA",
        "authorized_official_title_or_position": "SPEECH-LANGUAGE PATHOLOGIST",
        "authorized_official_telephone_number": "608-352-0650"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeffrey Dale Ford, SUDPT
• Joshua Cole Ford
• McKenzie L Ford, OTR/L
• Patrice Marie Ford
• Jennifer Forim, SLP
• Sandra L. Fornwalt, M.D.
• Aleana Danielle Forquer, LMP
• Matthew Donavon Forrester, MD
• Andrew B Forsyth, PH.D.
• Ryan Forsyth, PAC

• Speech-Language Pathologist in Spokane, WA
• Providers in Spokane, WA by specialty
• Speech-Language Pathologist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2025; 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.