Active NPI
Leah Jocelyn Davis, MED MS CCC SLP
- Speech-Language Pathologist
- Federal Way, WA
National Provider Identifier
1104997758
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- LL00002699
- Practice address
- 35535 6TH Place SW
Birth to Three Developmental Center
Federal Way, WA 98023 - Phone
- (253) 874-5445
- Fax
- (253) 874-0687
- NPI assigned
- Nov 13, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | LL00002699 | WA | Primary |
Addresses
Primary practice location
35535 6TH Place SW
Birth to Three Developmental Center
Federal Way, WA 98023
Mailing address
PO Box 24269
Birth to Three Developmental Center
Federal Way, WA 98093
Phone (253) 874-5445
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 12016916 | Other | NATIONAL ASHA | |
| 8344897 | Medicaid | WA | |
| 9812PE | Other | WA | REGENCE BLUE SHIELD |
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, Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LL00002699 | WA | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Birth to Three Developmental Center | 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.
-
- Physical Therapy Clinic/Center
- Federal Way, WA
- NPI 1609936624
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163376000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1104997758",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 24269",
"address_2": "BIRTH TO THREE DEVELOPMENTAL CENTER",
"city": "FEDERAL WAY",
"state": "WA",
"postal_code": "98093",
"telephone_number": "253-874-5445",
"fax_number": "253-874-0687"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "35535 6TH PLACE SW",
"address_2": "BIRTH TO THREE DEVELOPMENTAL CENTER",
"city": "FEDERAL WAY",
"state": "WA",
"postal_code": "98023",
"telephone_number": "253-874-5445",
"fax_number": "253-874-0687"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "LEAH",
"middle_name": "JOCELYN",
"name_prefix": "Mrs.",
"credential": "MED MS CCC SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-11-13",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "WA",
"license": "LL00002699",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NATIONAL ASHA",
"identifier": "12016916",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8344897",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "REGENCE BLUE SHIELD",
"identifier": "9812PE",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Federal Way, 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.