Active NPI
Dana Majors Wiggins
- Speech-Language Pathologist
- Clarkston, WA
National Provider Identifier
1154640720
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- SLP-1513
- Practice address
- 2452 17TH St
Clarkston, WA 99403-2988 - Phone
- (208) 305-2910
- NPI assigned
- May 21, 2010
- Sex
- Female
- Sole proprietor
- Yes
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 | SLP-1513 | ID | Primary |
Addresses
Primary practice location
2452 17TH St
Clarkston, WA 99403-2988
Mailing address
2452 17TH St
Clarkston, WA 99403-2988
Phone (208) 305-2910
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01096629 | Other | AMERICAN SPEECH LANGUAGE HEARING ASSOCIATION | |
| SLP-1513 | Other | ID | STATE OF IDAHO DEPARTMENT OF LICENSURE |
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 |
|---|---|---|---|
| SLP-1513 | ID | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1274400000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1274400000000",
"number": "1154640720",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2452 17TH ST",
"city": "CLARKSTON",
"state": "WA",
"postal_code": "994032988",
"telephone_number": "208-305-2910"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2452 17TH ST",
"city": "CLARKSTON",
"state": "WA",
"postal_code": "994032988",
"telephone_number": "208-305-2910"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WIGGINS",
"first_name": "DANA",
"middle_name": "MAJORS",
"name_prefix": "Dr.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-05-21",
"last_updated": "2010-05-21",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "ID",
"license": "SLP-1513",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AMERICAN SPEECH LANGUAGE HEARING ASSOCIATION",
"identifier": "01096629",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE OF IDAHO DEPARTMENT OF LICENSURE",
"identifier": "SLP-1513",
"state": "ID"
}
],
"endpoints": [],
"other_names": []
}Other providers in Clarkston, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.