Nicole Sarah Khvalabov, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

578981C Issued in WA

Practice address

2820 S Orcas St
Seattle, WA 98108-3066

Phone

(206) 252-6930

NPI assigned

Apr 28, 2025

Last updated

Apr 28, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

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

State licenses

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

{
    "created_epoch": "1745798400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745798400000",
    "number": "1457149858",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2520 APPLE HILL CT N",
            "city": "BUFFALO GROVE",
            "state": "IL",
            "postal_code": "600894650",
            "telephone_number": "847-212-5103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2820 S ORCAS ST",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981083066",
            "telephone_number": "206-252-6930"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHVALABOV",
        "first_name": "NICOLE",
        "middle_name": "SARAH",
        "credential": "CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-04-28",
        "last_updated": "2025-04-28",
        "certification_date": "2025-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "WA",
            "license": "578981C",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Speech-Language Pathologist in Seattle, WA
• Providers in Seattle, 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 Apr 28, 2025; 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.