Kevin Alan Risdon, CCC SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

60271740611 Issued in WA

Practice address

2371 Veedol Dr
East Wenatchee, WA 98802-9020

Phone

(509) 669-2025

NPI assigned

Nov 15, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1195084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1195084800000",
    "number": "1174704308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2371 VEEDOL DR",
            "city": "EAST WENATCHEE",
            "state": "WA",
            "postal_code": "988029020",
            "telephone_number": "509-669-2025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2371 VEEDOL DR",
            "city": "EAST WENATCHEE",
            "state": "WA",
            "postal_code": "988029020",
            "telephone_number": "509-669-2025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RISDON",
        "first_name": "KEVIN",
        "middle_name": "ALAN",
        "credential": "CCC SLP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-11-15",
        "last_updated": "2007-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "WA",
            "license": "60271740611",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Speech-Language Pathologist in East Wenatchee, WA
• Providers in East Wenatchee, WA by specialty
• Speech-Language Pathologist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2007; 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.