Nina E. Peterson, CCC-SP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

Practice address

4541 Lake Washington Blvd NE
Kirkland, WA 98033-7628

Phone

(425) 803-1886

NPI assigned

Aug 20, 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

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": "1187568000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1187568000000",
    "number": "1346433653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4541 LAKE WASHINGTON BLVD NE",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "980337628",
            "telephone_number": "425-803-1886"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4541 LAKE WASHINGTON BLVD NE",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "980337628",
            "telephone_number": "425-803-1886"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "NINA",
        "middle_name": "E.",
        "credential": "CCC-SP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-08-20",
        "last_updated": "2007-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "WA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lacey Peters
• Ruby Peters
• Jessica Peterson
• Jill Peterson, OTR/L
• Lisa Peterson
• Rebbecca Anne Peterson, LMP
• Robert Petit, ARNP
• Alan Petkov, DDS
• Sarah Elise Petricca, M.D.
• Trevor W. Petrie, OTR/L, CHT

• Speech-Language Pathologist in Kirkland, WA
• Providers in Kirkland, 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 Aug 20, 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.