Individual provider Active NPI

Rebecca Leigh Kraus, MS, CCC-SLP

  • Speech-Language Pathologist
  • Vancouver, WA
National Provider Identifier
1407325616
Registry record updated Nov 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
LL60904139 Issued in WA
Practice address
3000 NE 99TH St
Vancouver, WA 98665-9299
Phone
(360) 313-3400
NPI assigned
Nov 16, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2018

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 LL60904139 WA Primary

Addresses

Primary practice location

3000 NE 99TH St
Vancouver, WA 98665-9299

Mailing address

3342 NE 12TH Ave
Portland, OR 97212-2245

Other practice location 1

301 S Lieser Rd
Vancouver, WA 98664-2270
Phone (360) 313-4853

Other identifiers 1

IdentifierTypeStateIssuer
LL60904139MedicaidWA

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
LL60904139WAMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1542326400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1542326400000",
    "number": "1407325616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3342 NE 12TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972122245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 NE 99TH ST",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986659299",
            "telephone_number": "360-313-3400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "301 S Lieser Rd",
            "address_purpose": "LOCATION",
            "city": "Vancouver",
            "state": "WA",
            "postal_code": "986642270",
            "country_code": "US",
            "telephone_number": "360-313-4853",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KRAUS",
        "first_name": "REBECCA",
        "middle_name": "LEIGH",
        "credential": "MS, CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-16",
        "last_updated": "2018-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "WA",
            "license": "LL60904139",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "LL60904139",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Vancouver, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2018; 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.