Individual provider Active NPI

Kristi Elaine Wolswijk, M.A., CCC-SLP

  • Speech-Language Pathologist
  • Renton, WA
National Provider Identifier
1275656001
Registry record updated Dec 1, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
LL00003550 Issued in WA
Practice address
401 Olympia Ave NE
Suite 232
Renton, WA 98056-4117
Phone
(206) 200-3636
NPI assigned
Apr 8, 2007
Last updated
Dec 1, 2011By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 1, 2011

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 LL00003550 WA Primary

Addresses

Primary practice location

401 Olympia Ave NE
Suite 232
Renton, WA 98056-4117

Mailing address

6217 NE 4TH CT
Renton, WA 98059-4573
Phone (206) 200-3636

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
LL00003550WAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Access Speech & Language Therapy, Inc. Speech-Language Pathologist Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1175990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1322697600000",
    "number": "1275656001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6217 NE 4TH CT",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980594573",
            "telephone_number": "206-200-3636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 OLYMPIA AVE NE",
            "address_2": "SUITE 232",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980564117",
            "telephone_number": "206-200-3636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOLSWIJK",
        "first_name": "KRISTI",
        "middle_name": "ELAINE",
        "credential": "M.A., CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-08",
        "last_updated": "2011-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "WA",
            "license": "LL00003550",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Renton, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2011; 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.