Jaclyn Liana Colburn, MS, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

PENDING Issued in WA

Practice address

9050 385TH Ave SE
Snoqualmie, WA 98065

Phone

(425) 888-3347

NPI assigned

Jul 16, 2015

Last updated

Feb 9, 2024By 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 2

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Public Hospital District No 4 King County Washington

  dba Snoqualmie Valley Hospital

  • Critical Access Hospital
  • Snoqualmie, WA
  • NPI 1902846546
  Medicare reassignment NPD
• MMG Speech & Therapeutic Services, LLC

  • Speech-Language Pathologist
  • Lakewood, WA
  • NPI 1679940886
  NPD (past)

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

{
    "created_epoch": "1437004800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707436800000",
    "number": "1467836635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6768 E LEAFWOOD DR",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928075028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9050 385TH AVE SE",
            "city": "SNOQUALMIE",
            "state": "WA",
            "postal_code": "98065",
            "telephone_number": "425-888-3347"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "38243 SE 85th St",
            "address_purpose": "LOCATION",
            "city": "Snoqualmie",
            "state": "WA",
            "postal_code": "980659608",
            "country_code": "US",
            "telephone_number": "714-394-7325",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COLBURN",
        "first_name": "JACLYN",
        "middle_name": "LIANA",
        "name_prefix": "Mrs.",
        "credential": "MS, CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-16",
        "last_updated": "2024-02-09",
        "certification_date": "2024-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2355S0801X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Speech-Language Assistant",
            "state": "CA",
            "license": "3206",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "WA",
            "license": "PENDING",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alan Richard Chock, MD
• Carlene Chung, RPH
• Camille Rae Cirhan, LMP
• City of Snoqualmie
• Coalesce Wa PLLC
• Colleen T Peck MD PLLC
• Theresa Jean Colonna, COTA/L
• Colyn Nouv, DPM PLLC
• Colyn Nouv, DPM PLLC (Snoqualmie Foot and Ankle Clinic)
• Lisa Connors

• Speech-Language Pathologist in Snoqualmie, WA
• Providers in Snoqualmie, 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 Feb 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.