Active NPI
Rebecca Fenander, M.S., CCC-SLP
- Speech-Language Pathologist
- Kent, WA
National Provider Identifier
1467597583
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- LL00004407
- Practice address
- 10811 SE Kent Kangley Rd
Kent, WA 98030-7108 - Phone
- (253) 854-5660
- Fax
- (253) 854-7025
- NPI assigned
- Feb 20, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | LL00004407 | WA | Primary |
Addresses
Primary practice location
10811 SE Kent Kangley Rd
Kent, WA 98030-7108
Mailing address
2766 E 2850 S
Salt Lake City, UT 84109
Phone (206) 369-9644
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7018518 | Medicaid | WA |
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
| License | State | Type | Specialty |
|---|---|---|---|
| LL00004407 | WA | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171929600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1364342400000",
"number": "1467597583",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2766 E 2850 S",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "84109",
"telephone_number": "206-369-9644",
"fax_number": "253-854-7025"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10811 SE KENT KANGLEY RD",
"city": "KENT",
"state": "WA",
"postal_code": "980307108",
"telephone_number": "253-854-5660",
"fax_number": "253-854-7025"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FENANDER",
"first_name": "REBECCA",
"credential": "M.S., CCC-SLP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-02-20",
"last_updated": "2013-03-27",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "WA",
"license": "LL00004407",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "7018518",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Kent, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.