Individual provider Active NPI

Anagha Vivek Soman, CFYSLP

  • Speech-Language Pathologist
  • Everett, WA
National Provider Identifier
1366570814
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SI00004179 Issued in WA
Practice address
14 E Casino Rd
Everett, WA 98208-2628
Phone
(425) 523-1663
Fax
(425) 513-0917
NPI assigned
Feb 28, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 SI00004179 WA Primary

Addresses

Primary practice location

14 E Casino Rd
Everett, WA 98208-2628

Mailing address

6507 214TH Ave NE
Redmond, WA 98053-2311
Phone (425) 868-7774

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
SI00004179WAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Kindering Center Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1172620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1366570814",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6507 214TH AVE NE",
            "city": "REDMOND",
            "state": "WA",
            "postal_code": "980532311",
            "telephone_number": "425-868-7774",
            "fax_number": "425-513-0917"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14 E CASINO RD",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982082628",
            "telephone_number": "425-523-1663",
            "fax_number": "425-513-0917"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOMAN",
        "first_name": "ANAGHA",
        "middle_name": "VIVEK",
        "credential": "CFYSLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "WA",
            "license": "SI00004179",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Everett, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.