Active NPI
Dana Jacobson, SLP
- Speech-Language Pathologist
- Kirkland, WA
National Provider Identifier
1265427249
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- LL00001346
- Practice address
- 4311 106TH PL NE
Kirkland, WA 98033-7919 - Phone
- (425) 827-0505
- NPI assigned
- Sep 15, 2005
- 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 Pathologist | 235Z00000X | LL00001346 | WA | Primary |
Addresses
Primary practice location
4311 106TH PL NE
Kirkland, WA 98033-7919
Mailing address
4311 106TH PL NE
Kirkland, WA 98033-7919
Phone (425) 827-0505
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| LL00001346 | Other | WA | WA STATE SLP LICENSE |
| 8337990 | Other | WA | DSHS # |
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 |
|---|---|---|---|
| LL00001346 | WA | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1126742400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1350259200000",
"number": "1265427249",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4311 106TH PL NE",
"city": "KIRKLAND",
"state": "WA",
"postal_code": "980337919",
"telephone_number": "425-827-0505"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4311 106TH PL NE",
"city": "KIRKLAND",
"state": "WA",
"postal_code": "980337919",
"telephone_number": "425-827-0505"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACOBSON",
"first_name": "DANA",
"name_prefix": "Ms.",
"credential": "SLP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2005-09-15",
"last_updated": "2012-10-15",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "WA",
"license": "LL00001346",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WA STATE SLP LICENSE",
"identifier": "LL00001346",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DSHS #",
"identifier": "8337990",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Kirkland, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 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.