Active NPI
Sarah Elizabeth Johnston, M.S.
- Speech-Language Pathologist
- Lakewood, WA
National Provider Identifier
1194291716
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- SI60921539
- Practice address
- 8909 Gravelly Lake Dr SW Ste D
Lakewood, WA 98499-3101 - Phone
- (253) 753-4008
- NPI assigned
- Oct 22, 2018
- 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 | SI60921539 | WA | Primary |
Addresses
Primary practice location
8909 Gravelly Lake Dr SW Ste D
Lakewood, WA 98499-3101
Mailing address
8909 Gravelly Lake Dr SW Ste D
Lakewood, WA 98499-3101
Phone (253) 753-4008
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200605001624 | WA | Practitioner - Qualified Speech Language Pathologist | 2567883192 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SI60921539 | WA | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| MMG Speech & Therapeutic Services, LLC | Speech-Language Pathologist | Current | Accepting new patients |
Locations
9881 Bridgeport Way SW
Lakewood, WA 98499
Phone (253) 753-4008
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 and National Provider Directory roles.
-
- Speech-Language Pathologist
- Lakewood, WA
- NPI 1679940886
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1540166400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1545091200000",
"number": "1194291716",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8909 GRAVELLY LAKE DR SW STE D",
"city": "LAKEWOOD",
"state": "WA",
"postal_code": "984993101",
"telephone_number": "253-753-4008"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8909 GRAVELLY LAKE DR SW STE D",
"city": "LAKEWOOD",
"state": "WA",
"postal_code": "984993101",
"telephone_number": "253-753-4008"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSTON",
"first_name": "SARAH",
"middle_name": "ELIZABETH",
"name_prefix": "Miss",
"credential": "M.S.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-10-22",
"last_updated": "2018-12-18",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "WA",
"license": "SI60921539",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Lakewood, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.