Rebekah Nelson, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

LL61070996 Issued in WA

Practice address

29020 216TH Ave SE
Black Diamond, WA 98010-1274

Phone

(253) 854-5660

Fax

(253) 854-7025

NPI assigned

May 5, 2020

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 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Children'S Therapy Center

  • Specialist
  • Kent, WA
  • NPI 1528114469

  Multi-Specialty

  NPD (past)

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

{
    "created_epoch": "1588636800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588636800000",
    "number": "1427679042",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10811 SE KENT KANGLEY RD",
            "city": "KENT",
            "state": "WA",
            "postal_code": "980307108",
            "telephone_number": "253-854-5660",
            "fax_number": "253-854-7025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29020 216TH AVE SE",
            "city": "BLACK DIAMOND",
            "state": "WA",
            "postal_code": "980101274",
            "telephone_number": "253-854-5660",
            "fax_number": "253-854-7025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "REBEKAH",
        "credential": "CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-05-05",
        "last_updated": "2020-05-05",
        "certification_date": "2020-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "WA",
            "license": "LL61070996",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PENDING",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Selwyne Jei C. Matillano, RN
• Rachel McKee, SLP
• Julia McMichael, MS, CCC-SLP
• Chloe Marie Mirick, DDS
• Julie Lyn Murray, LMT
• Nicole Mariah Nielsen, DPT
• Heather Nicole O'Brien, LMP
• Private Healthcare Facilities
• Katie Marie Rhodes, RN, IBCLC
• Seneca Isla Rose, IBCLC

• Speech-Language Pathologist in Black Diamond, WA
• Providers in Black Diamond, 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 May 5, 2020; 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.