Karrie Janae Petersen, MS, CCC- SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

LL60302449 Issued in WA

Practice address

1220 Main St Ste 400
Vancouver, WA 98660-2963

Phone

(360) 230-8557

Fax

(888) 915-0898

NPI assigned

Sep 20, 2012

Last updated

Dec 20, 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 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

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.

• Cascade Clinic

  • Hearing and Speech Clinic/Center
  • Vancouver, WA
  • NPI 1063175644

  Speech-Language Pathologist

  NPD Authorized official
• Kidspace Therapy, LLC

  • Developmental Disabilities Clinic/Center
  • Longview, WA
  • NPI 1184019184
  NPD (past)
• Progress Center,Inc

  • Speech-Language Pathologist
  • Longview, WA
  • NPI 1497809636
  NPD (past)

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

{
    "created_epoch": "1348099200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703030400000",
    "number": "1346591153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1220 MAIN ST STE 400",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986602963",
            "telephone_number": "360-230-8557",
            "fax_number": "888-915-0898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1220 MAIN ST STE 400",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986602963",
            "telephone_number": "360-230-8557",
            "fax_number": "888-915-0898"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "300 W 8th St Unit 327",
            "address_purpose": "LOCATION",
            "city": "Vancouver",
            "state": "WA",
            "postal_code": "986603439",
            "country_code": "US",
            "telephone_number": "503-369-6326",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PETERSEN",
        "first_name": "KARRIE",
        "middle_name": "JANAE",
        "credential": "MS, CCC- SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-09-20",
        "last_updated": "2023-12-20",
        "certification_date": "2023-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "WA",
            "license": "LL60302449",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tonya Peters
• Petersen Investments, LLC (Columbia Compounding)
• Alina Ann Petersen, LMT
• Bryanne Petersen, BS, CDP
• Donald E. Petersen, ADDICTION THERAPIST
• Mari Petersen
• Markell Petersen, SUDP
• Tyler Daniel Petersen, D.O.
• Zoe Peterson-Lipetz
• Alex Michael Peterson, PHARM. D

• Speech-Language Pathologist in Vancouver, WA
• Providers in Vancouver, 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 20, 2023; 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.