Active NPI
Courtney Bryann Keen
- Speech-Language Assistant
- Yelm, WA
National Provider Identifier
1124733670
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Assistant
- License
- SP61361278
- Practice address
- 909 Mill Rd SE
Yelm, WA 98597-8572 - Phone
- (360) 951-5970
- NPI assigned
- Jan 19, 2023
- 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 Assistant | 2355S0801X | SP61361278 | WA | Primary |
Addresses
Primary practice location
909 Mill Rd SE
Yelm, WA 98597-8572
Mailing address
16633 Greenleaf Ave SE
Yelm, WA 98597-8827
Phone (360) 951-5970
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
| License | State | Type | Specialty |
|---|---|---|---|
| SP61361278 | WA | MD | Speech-Language Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1674086400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1674086400000",
"number": "1124733670",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16633 GREENLEAF AVE SE",
"city": "YELM",
"state": "WA",
"postal_code": "985978827",
"telephone_number": "360-951-5970"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "909 MILL RD SE",
"city": "YELM",
"state": "WA",
"postal_code": "985978572",
"telephone_number": "360-951-5970"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KEEN",
"first_name": "COURTNEY",
"middle_name": "BRYANN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-01-19",
"last_updated": "2023-01-19",
"certification_date": "2022-12-15",
"status": "A"
},
"taxonomies": [
{
"code": "2355S0801X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Speech-Language Assistant",
"state": "WA",
"license": "SP61361278",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Yelm, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 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.