NPIMap

Organization Active NPI

Kitsap Speech Language Pathology Services

  • Speech-Language Pathologist
  • Port Orchard, WA
National Provider Identifier
1295953909
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
LL00003353 Issued in WA
Legal business name
KITSAP SPEECH LANGUAGE PATHOLOGY SERVICES
Practice address
1008 Bethel Ave
Suite E
Port Orchard, WA 98366-4235
Phone
(360) 871-2076
Fax
(306) 895-0203
NPI assigned
Apr 20, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mrs. Gwendolyn Marie Torgerson, M.S.,CCC-SLPNPI 1386718955
Title
Speech-Language Pathologist
Phone
(360) 871-2076

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language PathologistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 235Z00000X LL00003353 WA Primary

Addresses

Primary practice location

1008 Bethel Ave
Suite E
Port Orchard, WA 98366-4235

Mailing address

2323 Steamboat Loop E
Port Orchard, WA 98366-4833
Phone (360) 871-2076

Other identifiers 1

IdentifierTypeStateIssuer
7127236MedicaidWA

Other names 1

  • Kitsap SLP Services Doing business as

National Provider Directory

National Provider Directory

Locations

1008 Bethel Ave
Ste E
Port Orchard, WA 98366
Phone (360) 871-2076

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1177027200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1295953909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2323 STEAMBOAT LOOP E",
            "city": "PORT ORCHARD",
            "state": "WA",
            "postal_code": "983664833",
            "telephone_number": "360-871-2076",
            "fax_number": "360-895-0203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1008 BETHEL AVE",
            "address_2": "SUITE E",
            "city": "PORT ORCHARD",
            "state": "WA",
            "postal_code": "983664235",
            "telephone_number": "360-871-2076",
            "fax_number": "306-895-0203"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KITSAP SPEECH LANGUAGE PATHOLOGY SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "TORGERSON",
        "authorized_official_first_name": "GWENDOLYN",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "SPEECH-LANGUAGE PATHOLOGIST",
        "authorized_official_telephone_number": "360-871-2076",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "M.S.,CCC-SLP"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "WA",
            "license": "LL00003353",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7127236",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kitsap SLP Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Port Orchard, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.