Individual provider Active NPI

Jean H Vandongen, M.ED.,CCC-SLP

  • Speech-Language Pathologist
  • Oak Harbor, WA
National Provider Identifier
1063962181
Registry record updated Oct 12, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
LL60683100 Issued in WA
Practice address
151 SE Midway Blvd
Oak Harbor, WA 98277-5082
Phone
(360) 279-5100
NPI assigned
Oct 12, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 12, 2016

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 LL60683100 WA Primary

Addresses

Primary practice location

151 SE Midway Blvd
Oak Harbor, WA 98277-5082

Mailing address

151 SE Midway Blvd
Oak Harbor, WA 98277-5082
Phone (360) 279-5100

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 Education

State licenses

LicenseStateTypeSpecialty
LL60683100WAMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1476230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476230400000",
    "number": "1063962181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "151 SE MIDWAY BLVD",
            "city": "OAK HARBOR",
            "state": "WA",
            "postal_code": "982775082",
            "telephone_number": "360-279-5100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "151 SE MIDWAY BLVD",
            "city": "OAK HARBOR",
            "state": "WA",
            "postal_code": "982775082",
            "telephone_number": "360-279-5100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDONGEN",
        "first_name": "JEAN",
        "middle_name": "H",
        "credential": "M.ED.,CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-10-12",
        "last_updated": "2016-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "WA",
            "license": "LL60683100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oak Harbor, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2016; 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.