Individual provider Active NPI

Sharlet Lee Jensen, MS CCC SLP

  • Speech-Language Pathologist
  • Mount Vernon, WA
National Provider Identifier
1053431791
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
LL00004205 Issued in WA
Practice address
320 Pacific PL
Mount Vernon, WA 98273-5463
Phone
(360) 416-7570
Fax
(360) 416-7580
NPI assigned
Mar 29, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 LL00004205 WA Primary

Addresses

Primary practice location

320 Pacific PL
Mount Vernon, WA 98273-5463

Mailing address

23801B Wallitner Rd
Arlington, WA 98223-6860
Phone (360) 435-3410

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)
Not enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
LL00004205WAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Skagit Preschool Association and Resource Center Speech-Language Pathologist Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1175126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1053431791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23801B WALLITNER RD",
            "city": "ARLINGTON",
            "state": "WA",
            "postal_code": "982236860",
            "telephone_number": "360-435-3410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 PACIFIC PL",
            "city": "MOUNT VERNON",
            "state": "WA",
            "postal_code": "982735463",
            "telephone_number": "360-416-7570",
            "fax_number": "360-416-7580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENSEN",
        "first_name": "SHARLET LEE",
        "name_prefix": "Miss",
        "credential": "MS CCC SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "WA",
            "license": "LL00004205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Vernon, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.