Individual provider Active NPI

Deanna Wesley

  • Speech-Language Pathologist
  • Vancouver, WA
National Provider Identifier
1124641147
Registry record updated Oct 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
LL61469325 Issued in WA
Practice address
7409 NE Hazel Dell Ave Ste 112
Vancouver, WA 98665-8337
Phone
(360) 597-4048
NPI assigned
May 26, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 09546 MD
Speech-Language Pathologist 235Z00000X 17651 OR
Speech-Language Pathologist 235Z00000X LL61469325 WA Primary

Addresses

Primary practice location

7409 NE Hazel Dell Ave Ste 112
Vancouver, WA 98665-8337

Mailing address

7409 NE Hazel Dell Ave Ste 112
Vancouver, WA 98665-8337
Phone (360) 597-4048

Other practice location 1

8645 SE Sunnybrook Blvd # 120
Clackamas, OR 97015-6841
Phone (503) 666-1333

Other practice location 2

115 Sudbrook Ln Ste A
Pikesville, MD 21208-4184
Phone (410) 358-1997

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

State licenses

LicenseStateTypeSpecialty
09546MDMDSpeech-Language Pathologist
17651ORMDSpeech-Language Pathologist
LL61469325WAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Speech and Occupational Specialists, LLC Speech-Language Pathologist PastSince Oct 29, 2023 Accepting new patients
Prism Pediatric Therapy Associates PLLC PastSince Oct 29, 2023 Accepting new patients

Organizations & group practices 2

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": "1590451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698105600000",
    "number": "1124641147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7409 NE HAZEL DELL AVE STE 112",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986658337",
            "telephone_number": "360-597-4048"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7409 NE HAZEL DELL AVE STE 112",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986658337",
            "telephone_number": "360-597-4048"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8645 SE Sunnybrook Blvd # 120",
            "address_purpose": "LOCATION",
            "city": "Clackamas",
            "state": "OR",
            "postal_code": "970156841",
            "country_code": "US",
            "telephone_number": "503-666-1333",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "115 Sudbrook Ln Ste A",
            "address_purpose": "LOCATION",
            "city": "Pikesville",
            "state": "MD",
            "postal_code": "212084184",
            "country_code": "US",
            "telephone_number": "410-358-1997",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WESLEY",
        "first_name": "DEANNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-05-26",
        "last_updated": "2023-10-24",
        "certification_date": "2023-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MD",
            "license": "09546",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "OR",
            "license": "17651",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "WA",
            "license": "LL61469325",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vancouver, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2023; 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.