Blue Sky Pediatric Speech Therapy, Inc.

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

LL00003279 Issued in WA

Legal business name

BLUE SKY PEDIATRIC SPEECH THERAPY, INC.

Practice address

14920 Westminster Way N Ste 1a
Shoreline, WA 98133-6445

Phone

(206) 306-9999

Fax

(206) 306-9997

NPI assigned

Mar 27, 2012

Last updated

Mar 27, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Myra Tishkoff, M.S., CCC-SLP

Title

Owner

Phone

(206) 306-9999

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Susan Christine Gruber, CCC SLP

  • Speech-Language Pathologist
  • Shoreline, WA
  • NPI 1790835965
  NPD (past)

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

{
    "created_epoch": "1332806400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1332806400000",
    "number": "1306112040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14920 WESTMINSTER WAY N STE 1A",
            "city": "SHORELINE",
            "state": "WA",
            "postal_code": "981336445",
            "telephone_number": "206-306-9999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14920 WESTMINSTER WAY N STE 1A",
            "city": "SHORELINE",
            "state": "WA",
            "postal_code": "981336445",
            "telephone_number": "206-306-9999",
            "fax_number": "206-306-9997"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUE SKY PEDIATRIC SPEECH THERAPY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-27",
        "last_updated": "2012-03-27",
        "status": "A",
        "authorized_official_last_name": "TISHKOFF",
        "authorized_official_first_name": "MYRA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "206-306-9999",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "M.S., CCC-SLP"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "WA",
            "license": "LL00003279",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1689735904",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Patrick William Black
• Suzanne K Bladek, APRN, BC
• Francesca Blasen, SLP
• Kurt Blomquist
• Erin Renee Blood
• Danielle Marie Bock, CPP, CDPT
• Zainab Bojang
• Jessica Boker
• Elisha Faye Bokman, N.D.
• Athena Bollozos

• Speech-Language Pathologist in Shoreline, WA
• Providers in Shoreline, 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 Mar 27, 2012; 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.