Jessica Wyatt, MS

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SI61472775 Issued in WA

Practice address

2745 38TH Ave
Longview, WA 98632-4721

Phone

(360) 575-7595

NPI assigned

Sep 5, 2023

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1693872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693872000000",
    "number": "1427834563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2715 LILAC ST",
            "city": "LONGVIEW",
            "state": "WA",
            "postal_code": "986323526"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2745 38TH AVE",
            "city": "LONGVIEW",
            "state": "WA",
            "postal_code": "986324721",
            "telephone_number": "360-575-7595"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WYATT",
        "first_name": "JESSICA",
        "name_prefix": "Mrs.",
        "credential": "MS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-09-05",
        "last_updated": "2023-09-05",
        "certification_date": "2023-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "WA",
            "license": "SI61472775",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kenneth R Wu, M.D.
• Robin Wulff
• Arvy Wuysang, MD
• Gare R Wyatt, MSW
• Jennifer Lynn Wyatt
• Grant J. Wylie
• Brittany Wynn, R-AAC, CPC
• Serena Xu, DDS
• Keith Boyce Yancey, OTR
• Eric Yang, M.D.

• Speech-Language Pathologist in Longview, WA
• Providers in Longview, 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 Sep 5, 2023; 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.