Individual provider Active NPI

Christin Jean Knechtges, MA, CCC-SLP

  • Speech-Language Pathologist
  • Medical Lake, WA
National Provider Identifier
1245582402
Registry record updated Oct 11, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
LL 60292763 Issued in WA
Practice address
541 S Evergreen Dr
Medical Lake, WA 99022-8901
Phone
(509) 368-1867
NPI assigned
Oct 11, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 11, 2012

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 60292763 WA Primary

Addresses

Primary practice location

541 S Evergreen Dr
Medical Lake, WA 99022-8901

Mailing address

541 S Evergreen Dr
Medical Lake, WA 99022-8901
Phone (509) 368-1867

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 Arts

State licenses

LicenseStateTypeSpecialty
LL 60292763WAMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1349913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349913600000",
    "number": "1245582402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "541 S EVERGREEN DR",
            "city": "MEDICAL LAKE",
            "state": "WA",
            "postal_code": "990228901",
            "telephone_number": "509-368-1867"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "541 S EVERGREEN DR",
            "city": "MEDICAL LAKE",
            "state": "WA",
            "postal_code": "990228901",
            "telephone_number": "509-368-1867"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KNECHTGES",
        "first_name": "CHRISTIN",
        "middle_name": "JEAN",
        "name_prefix": "Ms.",
        "credential": "MA, CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-10-11",
        "last_updated": "2012-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "WA",
            "license": "LL 60292763",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Medical Lake, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2012; 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.