Active NPI
Susan B Wiggins, M.ED, M.S
- Speech-Language Pathologist
- Portland, OR
National Provider Identifier
1235893082
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 17246
- Practice address
- 9750 NE Glisan St
Portland, OR 97220-4449 - Phone
- (503) 256-3920
- NPI assigned
- Oct 27, 2021
- 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 | 17246 | OR | Primary |
Addresses
Primary practice location
9750 NE Glisan St
Portland, OR 97220-4449
Mailing address
25117 SW Parkway Ave Ste D
Wilsonville, OR 97070-9697
Phone (971) 364-0611
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
- Credentials
- Master of Education, Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 17246 | OR | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1635292800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1635292800000",
"number": "1235893082",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "25117 SW PARKWAY AVE STE D",
"city": "WILSONVILLE",
"state": "OR",
"postal_code": "970709697",
"telephone_number": "971-364-0611"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9750 NE GLISAN ST",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972204449",
"telephone_number": "503-256-3920"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WIGGINS",
"first_name": "SUSAN",
"middle_name": "B",
"credential": "M.ED, M.S",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-10-27",
"last_updated": "2021-10-27",
"certification_date": "2021-10-27",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "OR",
"license": "17246",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Portland, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.