Active NPI
Jeanna Gibson, SLPA
- Speech-Language Assistant
- Ellensburg, WA
National Provider Identifier
1205384054
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Assistant
- License
- SP60655423
- Practice address
- 431 Brown Rd
Ellensburg, WA 98926-8995 - Phone
- (509) 306-0657
- NPI assigned
- Sep 21, 2016
- Sex
- Female
- Sole proprietor
- Yes
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 Assistant | 2355S0801X | SP60655423 | WA | Primary |
Addresses
Primary practice location
431 Brown Rd
Ellensburg, WA 98926-8995
Mailing address
2690 Sr 903
Cle Elum, WA 98922-8995
Phone (509) 649-4729
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 |
|---|---|---|---|
| SP60655423 | WA | MD | Speech-Language Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1474416000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1474416000000",
"number": "1205384054",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2690 SR 903",
"city": "CLE ELUM",
"state": "WA",
"postal_code": "989228995",
"telephone_number": "509-649-4729"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "431 BROWN RD",
"city": "ELLENSBURG",
"state": "WA",
"postal_code": "989268995",
"telephone_number": "509-306-0657"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GIBSON",
"first_name": "JEANNA",
"credential": "SLPA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-09-21",
"last_updated": "2016-09-21",
"status": "A"
},
"taxonomies": [
{
"code": "2355S0801X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Speech-Language Assistant",
"state": "WA",
"license": "SP60655423",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ellensburg, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.