Individual provider Active NPI

Sally Ann Christy

  • Speech-Language Pathologist
  • Poulsbo, WA
National Provider Identifier
1295203149
Registry record updated Nov 8, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
161339G Issued in WA
Practice address
569 NE Harrison St
Poulsbo, WA 98370-8403
Phone
(206) 715-1879
NPI assigned
Nov 8, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 8, 2018

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 161339G WA Primary

Addresses

Primary practice location

569 NE Harrison St
Poulsbo, WA 98370-8403

Mailing address

PO Box 1234
Poulsbo, WA 98370-0100
Phone (206) 715-1879

Other identifiers 1

IdentifierTypeStateIssuer
161339GMedicaidWA

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
161339GWAMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1541635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1541635200000",
    "number": "1295203149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1234",
            "city": "POULSBO",
            "state": "WA",
            "postal_code": "983700100",
            "telephone_number": "206-715-1879"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "569 NE HARRISON ST",
            "city": "POULSBO",
            "state": "WA",
            "postal_code": "983708403",
            "telephone_number": "206-715-1879"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHRISTY",
        "first_name": "SALLY",
        "middle_name": "ANN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-11-08",
        "last_updated": "2018-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "WA",
            "license": "161339G",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "161339G",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Poulsbo, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 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.

Verify at the official NPI Registry.