Kathleen Marie Porucznik, MACCC/SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

LL00004654 Issued in WA

Practice address

13954 NE 60TH Way Apt 110
Redmond, WA 98052-4544

Phone

(425) 890-0998

NPI assigned

Oct 9, 2007

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Ms. Kathy Porucznik Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1191888000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1191888000000",
    "number": "1295923886",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 MINOR AVE N UNIT 421",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981095463",
            "telephone_number": "216-337-3835"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13954 NE 60TH WAY APT 110",
            "city": "REDMOND",
            "state": "WA",
            "postal_code": "980524544",
            "telephone_number": "425-890-0998"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PORUCZNIK",
        "first_name": "KATHLEEN",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "MACCC/SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-10-09",
        "last_updated": "2007-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "WA",
            "license": "LL00004654",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHY",
            "last_name": "PORUCZNIK",
            "prefix": "MS.",
            "credential": "MACCC/SLP",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Natalia Pokataeva
• Anton H Poon, RPH
• Eric Poon, OT
• Adriana Maria Popescu, DDS
• Courtney Michele Porter, DC, MS
• Vanessa Poston
• Donald E Potter, M.D.
• Kathy Strande Pouncy, LMP
• Ronald O. Powell, PHD
• Tina Margareta Powell, APRN

• Speech-Language Pathologist in Redmond, WA
• Providers in Redmond, WA by specialty
• Speech-Language Pathologist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2007; 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.