Active NPI
Kennedy Klein
- Speech-Language Pathologist
- Tumwater, WA
National Provider Identifier
1174361034
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- SI61568840
- Practice address
- 2584 R W Johnson Blvd SW Unit 100
Tumwater, WA 98512-6103 - Phone
- (306) 489-6485
- NPI assigned
- Jul 16, 2024
- 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 | SI61568840 | WA | Primary |
Addresses
Primary practice location
2584 R W Johnson Blvd SW Unit 100
Tumwater, WA 98512-6103
Mailing address
285 Pinehurst Dr SW Apt 303
Tumwater, WA 98501-5228
Phone (715) 853-4563
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 |
|---|---|---|---|
| SI61568840 | WA | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Discovering Expression Speech and Language Inc | Speech-Language Pathologist | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Speech-Language Pathologist
- Lacey, WA
- NPI 1881234466
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1721088000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1733788800000",
"number": "1174361034",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "285 PINEHURST DR SW APT 303",
"city": "TUMWATER",
"state": "WA",
"postal_code": "985015228",
"telephone_number": "715-853-4563"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2584 R W JOHNSON BLVD SW UNIT 100",
"city": "TUMWATER",
"state": "WA",
"postal_code": "985126103",
"telephone_number": "306-489-6485"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KLEIN",
"first_name": "KENNEDY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-07-16",
"last_updated": "2024-12-10",
"certification_date": "2024-12-10",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "WA",
"license": "SI61568840",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tumwater, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.