Nicole Christine Hathaway, MA, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

15438 Issued in OR

Practice address

6530 SW 30TH Ave
Portland, OR 97239-1007

Phone

(503) 244-7533

NPI assigned

Jun 30, 2011

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

State licenses

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

{
    "created_epoch": "1309392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1418860800000",
    "number": "1235426099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 JEFFERSON PKWY APT C1",
            "city": "LAKE OSWEGO",
            "state": "OR",
            "postal_code": "970358892",
            "telephone_number": "602-653-9299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6530 SW 30TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972391007",
            "telephone_number": "503-244-7533"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HATHAWAY",
        "first_name": "NICOLE",
        "middle_name": "CHRISTINE",
        "credential": "MA, CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-06-30",
        "last_updated": "2014-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "AZ",
            "license": "SLP6141",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "OR",
            "license": "15438",
            "primary": true
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "UT",
            "license": "87631074102",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anneke P Hathaway, PSYD
• Chalese Marie Hathaway, DC
• Charles Richard Hathaway, D.C
• Jill L. Hathaway, LAC
• Mark Allen Hathaway
• Norma Hathaway, RN
• Sharon M Hatrak
• Amber Jo Hatt, LCSW
• Alberta Koch Hattem, PHD
• Barbara D. Hatten, M.S., R.D.

• Speech-Language Pathologist in Portland, OR
• Providers in Portland, OR by specialty
• Speech-Language Pathologist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2014; 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.