Jesica C Pruitt, MS, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

LL00004202 Issued in WA

Practice address

9818 NE 200TH St
Bothell, WA 98011-2300

Phone

(425) 941-3768

NPI assigned

Nov 29, 2006

Last updated

Sep 12, 2008By the provider in NPPES

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

Other identifiers 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1164758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1221177600000",
    "number": "1366519001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9818 NE 200TH ST",
            "city": "BOTHELL",
            "state": "WA",
            "postal_code": "980112300",
            "telephone_number": "425-941-3768"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9818 NE 200TH ST",
            "city": "BOTHELL",
            "state": "WA",
            "postal_code": "980112300",
            "telephone_number": "425-941-3768"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRUITT",
        "first_name": "JESICA",
        "middle_name": "C",
        "name_prefix": "Mrs.",
        "credential": "MS, CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-29",
        "last_updated": "2008-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "WA",
            "license": "LL00004202",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7028319",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8461469",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ASHA NUMBER",
            "identifier": "12090673",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PROVIDER NUMBER",
            "identifier": "7411852",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Andrea Prescott
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• Prime Care PLLC (Clear Solution Care PLLC)
• Logan Prock
• Katherine Fey Proctor, OT
• Puget Sound Psychiatric Center
• Puget Sound Psychiatric Center, PS (PSPC)
• Puget Sound Psychiatric Services
• Christopher D Pugh, LMHC
• Breanna Elizabeth Purzycki, OTR/L

• Speech-Language Pathologist in Bothell, WA
• Providers in Bothell, 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 Sep 12, 2008; 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.