Andrea Palazzolo, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

60986630 Issued in WA

Practice address

301 Old Highway 99 SE
Tenino, WA 98589-9370

Phone

(360) 264-3400

NPI assigned

Jul 21, 2021

Last updated

Jul 21, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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

• Tenino School District

  • Local Education Agency (LEA)
  • Tenino, WA
  • NPI 1609979541
  NPD (past)

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

{
    "created_epoch": "1626825600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626825600000",
    "number": "1104499847",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16021 KESTREL DR",
            "city": "HUNTERTOWN",
            "state": "IN",
            "postal_code": "467489273",
            "telephone_number": "260-435-9465"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 OLD HIGHWAY 99 SE",
            "city": "TENINO",
            "state": "WA",
            "postal_code": "985899370",
            "telephone_number": "360-264-3400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PALAZZOLO",
        "first_name": "ANDREA",
        "credential": "CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-07-21",
        "last_updated": "2021-07-21",
        "certification_date": "2021-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "WA",
            "license": "60986630",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "N/a",
            "affiliation": "N",
            "address_1": "301 Old Highway 99 SE",
            "city": "Tenino",
            "state": "WA",
            "country_code": "US",
            "postal_code": "985899370",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Ashley A Mbabazi, OT/L
• Margaret McEwen
• Rose Maria Morton, LMP
• Natural Wellness PLLC (Tenino Chiropractic & Natural Wellness Center)
• Christopher Page, LMP
• R & D Coulson Inc. (Tenino Clinic of Chiropractic)
• Martha Flittie Reid
• Jessyka Alexis-Marie Ritzman
• Michael Gene Rucker, LPO
• Scatter Creek Prosthetics Inc.

• Speech-Language Pathologist in Tenino, WA
• Providers in Tenino, 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 Jul 21, 2021; 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.