Individual provider Active NPI

M. Yvonne Brooks, MA-CCC/SLP

  • Speech-Language Pathologist
  • Bothell, WA
National Provider Identifier
1265786164
Registry record updated Oct 31, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
LL 00001572 Issued in WA
Practice address
19705 88TH Ave NE
Bothell, WA 98011-2121
Phone
(425) 408-5583
Fax
(425) 408-5572
NPI assigned
Oct 31, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 31, 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 00001572 WA Primary

Addresses

Primary practice location

19705 88TH Ave NE
Bothell, WA 98011-2121

Mailing address

19705 88TH Ave NE
Bothell, WA 98011
Phone (425) 408-5583

Other names 1

  • M Yvonne Wernicke-Brooks Professional name

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 00001572WAMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1351641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1351641600000",
    "number": "1265786164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19705 88TH AVE NE",
            "city": "BOTHELL",
            "state": "WA",
            "postal_code": "98011",
            "telephone_number": "425-408-5583",
            "fax_number": "425-408-5572"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19705 88TH AVE NE",
            "city": "BOTHELL",
            "state": "WA",
            "postal_code": "980112121",
            "telephone_number": "425-408-5583",
            "fax_number": "425-408-5572"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROOKS",
        "first_name": "M.",
        "middle_name": "YVONNE",
        "credential": "MA-CCC/SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-31",
        "last_updated": "2012-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "WA",
            "license": "LL 00001572",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "M",
            "last_name": "WERNICKE-BROOKS",
            "middle_name": "YVONNE",
            "credential": "MA-CCC/SLP",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Bothell, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 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.