Individual provider Active NPI

Jaime C Haywood, CCC-SLP

  • Speech-Language Pathologist
  • Port Angeles, WA
National Provider Identifier
1215487988
Registry record updated Mar 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
LL 60279050 Issued in WA
Practice address
216 E 4TH St
Port Angeles, WA 98362-3200
Phone
(360) 457-8575
NPI assigned
Oct 6, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 13, 2023

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 LL 60279050 WA Primary

Addresses

Primary practice location

216 E 4TH St
Port Angeles, WA 98362-3200

Mailing address

9142 Mountain Sunrise St SE
Yelm, WA 98597-8772
Phone (801) 839-9492

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
LL 60279050WAMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1475712000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678665600000",
    "number": "1215487988",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9142 MOUNTAIN SUNRISE ST SE",
            "city": "YELM",
            "state": "WA",
            "postal_code": "985978772",
            "telephone_number": "801-839-9492"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "216 E 4TH ST",
            "city": "PORT ANGELES",
            "state": "WA",
            "postal_code": "983623200",
            "telephone_number": "360-457-8575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAYWOOD",
        "first_name": "JAIME",
        "middle_name": "C",
        "credential": "CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-10-06",
        "last_updated": "2023-03-13",
        "certification_date": "2023-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "WA",
            "license": "LL 60279050",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Angeles, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2023; 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.