Individual provider Active NPI

Jennifer Bonaro Vanderwerff, SLP

  • Speech-Language Pathologist
  • Shoreline, WA
National Provider Identifier
1336283282
Registry record updated Dec 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
LL00004122 Issued in WA
Practice address
222 NW 200TH St
Shoreline, WA 98177-2517
Phone
(206) 228-2729
Fax
(206) 691-8698
NPI assigned
Feb 16, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 17, 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 LL00004122 WA Primary

Addresses

Primary practice location

222 NW 200TH St
Shoreline, WA 98177-2517

Mailing address

222 NW 200TH St
Shoreline, WA 98177-2517
Phone (206) 228-2729

Other names 1

  • Jennifer M Bonaro Former name

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
LL00004122WAMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1171584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545004800000",
    "number": "1336283282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "222 NW 200TH ST",
            "city": "SHORELINE",
            "state": "WA",
            "postal_code": "981772517",
            "telephone_number": "206-228-2729",
            "fax_number": "206-691-8698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 NW 200TH ST",
            "city": "SHORELINE",
            "state": "WA",
            "postal_code": "981772517",
            "telephone_number": "206-228-2729",
            "fax_number": "206-691-8698"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDERWERFF",
        "first_name": "JENNIFER",
        "middle_name": "BONARO",
        "name_prefix": "Mrs.",
        "credential": "SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-16",
        "last_updated": "2018-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "WA",
            "license": "LL00004122",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "BONARO",
            "middle_name": "M",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Shoreline, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 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.