Individual provider Active NPI

Maggie Nuese, SLP

  • Speech-Language Pathologist
  • Olympia, WA
National Provider Identifier
1174919922
Registry record updated Apr 8, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
LL60538292 Issued in WA
Practice address
2401 Bristol CT SW Ste D103
Olympia, WA 98502-6037
Phone
(360) 357-3339
NPI assigned
Apr 8, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 8, 2015

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 LL60538292 WA Primary

Addresses

Primary practice location

2401 Bristol CT SW Ste D103
Olympia, WA 98502-6037

Mailing address

812 S 6TH Ave SW
Tumwater, WA 98512-6817
Phone (360) 402-9241

Other identifiers 1

IdentifierTypeStateIssuer
LL60538292OtherWASTATE HEALTH LICENSE

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

LicenseStateTypeSpecialty
LL60538292WAMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1428451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1428451200000",
    "number": "1174919922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "812 S 6TH AVE SW",
            "city": "TUMWATER",
            "state": "WA",
            "postal_code": "985126817",
            "telephone_number": "360-402-9241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2401 BRISTOL CT SW STE D103",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985026037",
            "telephone_number": "360-357-3339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NUESE",
        "first_name": "MAGGIE",
        "credential": "SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-04-08",
        "last_updated": "2015-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "WA",
            "license": "LL60538292",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE HEALTH LICENSE",
            "identifier": "LL60538292",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Olympia, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2015; 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.