Individual provider Active NPI

Alexander Rubic, MS, CCC-SLP

  • Speech-Language Pathologist
  • Vancouver, WA
National Provider Identifier
1437551439
Registry record updated Sep 22, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
503482B Issued in WA
Practice address
11200 NE Rosewood Ave
Vancouver, WA 98662-5447
Phone
(360) 604-6300
NPI assigned
Sep 22, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2014

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 503482B WA Primary

Addresses

Primary practice location

11200 NE Rosewood Ave
Vancouver, WA 98662-5447

Mailing address

4501 N Concord Ave
Portland, OR 97217-3352
Phone (503) 481-1799

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
503482BWAMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1411344000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1411344000000",
    "number": "1437551439",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4501 N CONCORD AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972173352",
            "telephone_number": "503-481-1799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11200 NE ROSEWOOD AVE",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986625447",
            "telephone_number": "360-604-6300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUBIC",
        "first_name": "ALEXANDER",
        "credential": "MS, CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-09-22",
        "last_updated": "2014-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "WA",
            "license": "503482B",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Sep 22, 2014; 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.