NPIMap

Organization Active NPI

Pediatric Speech & Lang Assocs

  • Speech-Language Pathologist
  • Issaquah, WA
National Provider Identifier
1437142874
Registry record updated Jun 23, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
LL00001411 Issued in WA
Legal business name
PEDIATRIC SPEECH & LANG ASSOCS
Practice address
710 NW Juniper St
Suite 110
Issaquah, WA 98027-2717
Phone
(425) 392-2631
Fax
(425) 392-4631
NPI assigned
Aug 30, 2005
Last updated
Jun 23, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2008

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

Authorized official

Name
Mrs. Nancy M Lestz, MA,CCC-SLPNPI 1023002409
Title
Owner/SLP
Phone
(425) 392-2631

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X LL00001411 WA Primary

Addresses

Primary practice location

710 NW Juniper St
Suite 110
Issaquah, WA 98027-2717

Mailing address

710 NW Juniper St
Suite 110
Issaquah, WA 98027-2717
Phone (425) 392-2631

Other identifiers 1

IdentifierTypeStateIssuer
7027527MedicaidWA

National Provider Directory

National Provider Directory

Locations

710 NW Juniper St
Ste 110
Issaquah, WA 98027
Phone (425) 269-9100

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1125360000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214179200000",
    "number": "1437142874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "710 NW JUNIPER ST",
            "address_2": "SUITE 110",
            "city": "ISSAQUAH",
            "state": "WA",
            "postal_code": "980272717",
            "telephone_number": "425-392-2631",
            "fax_number": "425-392-4631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "710 NW JUNIPER ST",
            "address_2": "SUITE 110",
            "city": "ISSAQUAH",
            "state": "WA",
            "postal_code": "980272717",
            "telephone_number": "425-392-2631",
            "fax_number": "425-392-4631"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC SPEECH & LANG ASSOCS",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-30",
        "last_updated": "2008-06-23",
        "status": "A",
        "authorized_official_last_name": "LESTZ",
        "authorized_official_first_name": "NANCY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER/SLP",
        "authorized_official_telephone_number": "425-392-2631",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MA,CCC-SLP"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "WA",
            "license": "LL00001411",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7027527",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Issaquah, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2008; 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.