Individual provider Active NPI

Kathryn L Waltman, MA, CCC-SLP

  • Speech-Language Pathologist
  • Federal Way, WA
National Provider Identifier
1154766012
Registry record updated May 6, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
LL 60338058 Issued in WA
Practice address
3015 S 368TH St
Federal Way, WA 98003-7669
Phone
(253) 945-3715
Fax
(253) 945-2177
NPI assigned
May 6, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 6, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X LL 60338058 WA Primary

Addresses

Primary practice location

3015 S 368TH St
Federal Way, WA 98003-7669

Mailing address

33330 8TH Ave S
Federal Way, WA 98003-6325
Phone (253) 945-2086

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 Arts

State licenses

LicenseStateTypeSpecialty
LL 60338058WAMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1367798400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1367798400000",
    "number": "1154766012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33330 8TH AVE S",
            "city": "FEDERAL WAY",
            "state": "WA",
            "postal_code": "980036325",
            "telephone_number": "253-945-2086",
            "fax_number": "253-945-2177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3015 S 368TH ST",
            "city": "FEDERAL WAY",
            "state": "WA",
            "postal_code": "980037669",
            "telephone_number": "253-945-3715",
            "fax_number": "253-945-2177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALTMAN",
        "first_name": "KATHRYN",
        "middle_name": "L",
        "name_prefix": "Mrs.",
        "credential": "MA, CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-05-06",
        "last_updated": "2013-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "WA",
            "license": "LL 60338058",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 May 6, 2013; 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.