Individual provider Active NPI

Keesha Renae Sarman, MS, CF-SLP

  • Speech-Language Pathologist
  • Portland, OR
National Provider Identifier
1376184242
Registry record updated Mar 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
17863 Issued in OR
Practice address
17020 SW Upper Boones Ferry Rd Ste 201
Portland, OR 97224-7078
Phone
(503) 894-1539
Fax
(971) 353-5182
NPI assigned
Oct 2, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 17863 OR Primary
Behavior Technician 106S00000X

Addresses

Primary practice location

17020 SW Upper Boones Ferry Rd Ste 201
Portland, OR 97224-7078

Mailing address

17020 SW Upper Boones Ferry Rd Ste 201
Portland, OR 97224-7078
Phone (503) 894-1539

Other practice location 1

1800 NW 169th Pl Ste B100
Beaverton, OR 97006-7362
Phone (503) 350-7050

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
17863ORMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Play Connections Autism Services PastSince Oct 1, 2019 Accepting new patients
Parkwood Clinic LLC Speech-Language Pathologist PastSince Mar 17, 2024 Accepting new patients

Organizations & group practices 2

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": "1569974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710374400000",
    "number": "1376184242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17020 SW UPPER BOONES FERRY RD STE 201",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972247078",
            "telephone_number": "503-894-1539"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17020 SW UPPER BOONES FERRY RD STE 201",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972247078",
            "telephone_number": "503-894-1539",
            "fax_number": "971-353-5182"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1800 NW 169th Pl Ste B100",
            "address_purpose": "LOCATION",
            "city": "Beaverton",
            "state": "OR",
            "postal_code": "970067362",
            "country_code": "US",
            "telephone_number": "503-350-7050",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SARMAN",
        "first_name": "KEESHA",
        "middle_name": "RENAE",
        "credential": "MS, CF-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-02",
        "last_updated": "2024-03-14",
        "certification_date": "2024-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "OR",
            "license": "17863",
            "primary": true
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2024; 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.