Active NPI
Carrie W Taylor, M.S., CCC-SLP
- Speech-Language Pathologist
- Lacey, WA
National Provider Identifier
1265908503
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- LL60868497
- Practice address
- 6211 Mullen Rd SE
Lacey, WA 98503-7146 - Phone
- (360) 412-4600
- NPI assigned
- Oct 14, 2018
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | SP18878 | CA | |
| Speech-Language Pathologist | 235Z00000X | LL60868497 | WA | Primary |
Addresses
Primary practice location
6211 Mullen Rd SE
Lacey, WA 98503-7146
Mailing address
6434 Jeffrey CT SE
Lacey, WA 98513-6531
Phone (707) 490-4811
Other practice location 1
7600 5th Ave SE
Lacey, WA 98503-1521
Phone (360) 412-4610
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 12133177 | Other | AMERICAN SPEECH-LANGUAGE-HEARING ASSOCIATION | |
| LL60868497 | Other | WA | WASHINGTON STATE SPEECH LANGUAGE PATHOLOGY LICENSE |
Other names 1
- Carrie Christine Wallis
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 Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SP18878 | CA | MD | Speech-Language Pathologist |
| LL60868497 | WA | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1539475200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1539475200000",
"number": "1265908503",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6434 JEFFREY CT SE",
"city": "LACEY",
"state": "WA",
"postal_code": "985136531",
"telephone_number": "707-490-4811"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6211 MULLEN RD SE",
"city": "LACEY",
"state": "WA",
"postal_code": "985037146",
"telephone_number": "360-412-4600"
}
],
"practiceLocations": [
{
"address_1": "7600 5th Ave SE",
"address_purpose": "LOCATION",
"city": "Lacey",
"state": "WA",
"postal_code": "985031521",
"country_code": "US",
"telephone_number": "360-412-4610",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "TAYLOR",
"first_name": "CARRIE",
"middle_name": "W",
"name_prefix": "Mrs.",
"credential": "M.S., CCC-SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-10-14",
"last_updated": "2018-10-14",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "CA",
"license": "SP18878",
"primary": false
},
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "WA",
"license": "LL60868497",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AMERICAN SPEECH-LANGUAGE-HEARING ASSOCIATION",
"identifier": "12133177",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WASHINGTON STATE SPEECH LANGUAGE PATHOLOGY LICENSE",
"identifier": "LL60868497",
"state": "WA"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "CARRIE",
"last_name": "WALLIS",
"middle_name": "CHRISTINE",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Lacey, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.