Cheyenne Janay Gordon, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

LL61426839 Issued in WA

Practice address

4407 116TH St NE
Marysville, WA 98271-8568

Phone

(425) 418-8373

NPI assigned

Oct 29, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1730160000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730160000000",
    "number": "1063234102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23511 56TH AVE W UNIT 211",
            "city": "MOUNTLAKE TERRACE",
            "state": "WA",
            "postal_code": "980435279",
            "telephone_number": "425-418-8373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4407 116TH ST NE",
            "city": "MARYSVILLE",
            "state": "WA",
            "postal_code": "982718568",
            "telephone_number": "425-418-8373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORDON",
        "first_name": "CHEYENNE",
        "middle_name": "JANAY",
        "credential": "CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-10-29",
        "last_updated": "2024-10-29",
        "certification_date": "2024-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "WA",
            "license": "LL61426839",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Golden Opportunities and Local Support
• Pauline Vintapatr Golez
• Andrea Karina Gonzalez, MD
• Cody Good, OD
• Jennifer L Good, LMP
• Kristine Marie Gordon, LMP
• Gregory Joseph Gosch, D.D.S.
• Mindy Graber, M.S., LMHC
• Grace Bible Church of Marysville (Grace Academy)
• Grace Connection Services

• Speech-Language Pathologist in Marysville, WA
• Providers in Marysville, 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 29, 2024; 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.