Cecilia Marie Goedert, MA CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

LL61202947 Issued in WA

Practice address

15809 Bear Creek Pkwy Ste 100
Redmond, WA 98052-1542

Phone

(425) 882-6100

Fax

(844) 660-0701

NPI assigned

Aug 8, 2021

Last updated

Dec 14, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Cecilia Smith Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

State licenses

Practice roles

Locations

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.

• Kaiser Foundation Health Plan of Washington

  • Multi-Specialty Clinic/Center
  • Seattle, WA
  • NPI 1396810701
  Medicare reassignment NPD
• Kaiser Foundation Health Plan of Washington

  dba Everett Medical Center

  • Multi-Specialty Clinic/Center
  • Everett, WA
  • NPI 1386935351
  NPD
• Kaiser Foundation Health Plan of Washington

  • Multi-Specialty Clinic/Center
  • Renton, WA
  • NPI 1669619870
  NPD
• Peacehealth

  dba St. John Medical Center-PeaceHealth Therapy and Wellness

  • Prosthetic/Orthotic Supplier
  • Longview, WA
  • NPI 1184106437
  NPD (past)
• New Horizons Wellness Services, LLC

  • Clinical Psychologist
  • Beaverton, OR
  • NPI 1477801454
  NPD (past)

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

{
    "created_epoch": "1628380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702512000000",
    "number": "1306510763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15809 BEAR CREEK PKWY STE 100",
            "city": "REDMOND",
            "state": "WA",
            "postal_code": "980521542",
            "telephone_number": "425-882-6100",
            "fax_number": "844-660-0701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15809 BEAR CREEK PKWY STE 100",
            "city": "REDMOND",
            "state": "WA",
            "postal_code": "980521542",
            "telephone_number": "425-882-6100",
            "fax_number": "844-660-0701"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13333 SW 68th Pkwy Ste 20",
            "address_purpose": "LOCATION",
            "city": "Tigard",
            "state": "OR",
            "postal_code": "972239354",
            "country_code": "US",
            "telephone_number": "503-352-0240",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "325 9th Ave",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981042420",
            "country_code": "US",
            "telephone_number": "206-744-4607",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1015 NW 22nd Ave",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972103025",
            "country_code": "US",
            "telephone_number": "503-413-7151",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1015 Ocean Beach Hwy Ste 16",
            "address_purpose": "LOCATION",
            "city": "Longview",
            "state": "WA",
            "postal_code": "986324098",
            "country_code": "US",
            "telephone_number": "360-501-3750",
            "fax_number": "360-501-3755",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GOEDERT",
        "first_name": "CECILIA",
        "middle_name": "MARIE",
        "credential": "MA CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-08",
        "last_updated": "2023-12-14",
        "certification_date": "2022-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "OR",
            "license": "17190",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "WA",
            "license": "LL61202947",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwa.kp.org:14430/Interconnect-CE-PRD/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "15809 Bear Creek Pkwy Ste 100",
            "city": "Redmond",
            "state": "WA",
            "country_code": "US",
            "postal_code": "980521542",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "CECILIA",
            "last_name": "SMITH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Whitney Given I
• GJSC, LLC (Designed Clinical Nutrition)
• Kayla Leanne Gladem-West
• Stephen Andrew Glenn, BA, RC
• Kamil D Glover
• Tracy Lynn Goergen
• Gold's Health & Performance
• Jeanne Goldbloom, OTR
• Jon-Erik Golob, MS, OTR/L
• Faith Maryanne Golomb

• 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 Dec 14, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.