Individual provider Active NPI

Merissa Ekman, CCC-SLP

  • Speech-Language Pathologist
  • Bremerton, WA
National Provider Identifier
1396409777
Registry record updated Oct 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
LL60845116 Issued in WA
Practice address
333 S Charleston Ave Apt C
Bremerton, WA 98312-4285
Phone
(505) 980-2517
NPI assigned
Oct 22, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2021

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 LL60845116 WA Primary

Addresses

Primary practice location

333 S Charleston Ave Apt C
Bremerton, WA 98312-4285

Mailing address

333 S Charleston Ave Apt C
Bremerton, WA 98312-4285
Phone (505) 980-2517

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
LL60845116WAMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1634860800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634860800000",
    "number": "1396409777",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 S CHARLESTON AVE APT C",
            "city": "BREMERTON",
            "state": "WA",
            "postal_code": "983124285",
            "telephone_number": "505-980-2517"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 S CHARLESTON AVE APT C",
            "city": "BREMERTON",
            "state": "WA",
            "postal_code": "983124285",
            "telephone_number": "505-980-2517"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EKMAN",
        "first_name": "MERISSA",
        "credential": "CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-22",
        "last_updated": "2021-10-22",
        "certification_date": "2021-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "WA",
            "license": "LL60845116",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bremerton, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2021; 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.