Alexandra Sonja Kissin, SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

LL60236854 Issued in WA

Practice address

402 15TH Ave SE Ste 100
Puyallup, WA 98372-3709

Phone

(253) 697-5200

Fax

(253) 697-5248

NPI assigned

Sep 26, 2011

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)

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.

• Center for Speech, Language and Learning, Inc.

  dba Center for Speech Language Lea

  • Speech-Language Pathologist
  • Oakdale, MN
  • NPI 1164588307
  NPD (past)
• Center for Speech, Language, and Learning, Inc.

  • Hearing and Speech Clinic/Center
  • Oakdale, MN
  • NPI 1588592471
  NPD (past)

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

{
    "created_epoch": "1316995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1316995200000",
    "number": "1457634438",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "402 15TH AVE SE STE 100",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983723709",
            "telephone_number": "253-697-5200",
            "fax_number": "253-697-5248"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "402 15TH AVE SE STE 100",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983723709",
            "telephone_number": "253-697-5200",
            "fax_number": "253-697-5248"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KISSIN",
        "first_name": "ALEXANDRA",
        "middle_name": "SONJA",
        "credential": "SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-09-26",
        "last_updated": "2011-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "WA",
            "license": "LL60236854",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anne E. Kirk, MD
• David Daniel Kirk, DPT
• Kirks Pharmacy at Hartland, Inc. (Kirk's Pharmacy and Compounding)
• Kirks Pharmacy at Hartland, Inc. (Kirk's Pharmacy and Compounding)
• Vivian Kisanga, PMHNP-BC
• Danae Elaine Kissner, PA
• Millenia Wu Kitikul, DMD
• Anthony J Klaassen, M.D.
• Christina Noel Klas, BS
• Klein Chiropractic Clinic

• Speech-Language Pathologist in Puyallup, WA
• Providers in Puyallup, 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 26, 2011; 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.