Jessica Leigh Bullock

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

LL61041281 Issued in WA

Practice address

16508 SE 24TH St Ste 204
Vancouver, WA 98683-4321

Phone

(503) 970-8092

NPI assigned

Apr 1, 2020

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)

Not enrolled

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 and National Provider Directory roles.

• Blue Jay Speech & Language Therapy Services, LLC

  • Speech-Language Pathologist
  • Vancouver, WA
  • NPI 1538786306
  NPD Authorized official

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

{
    "created_epoch": "1585699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585699200000",
    "number": "1477182525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16508 SE 24TH ST STE 204",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986834321",
            "telephone_number": "503-970-8092"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16508 SE 24TH ST STE 204",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986834321",
            "telephone_number": "503-970-8092"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BULLOCK",
        "first_name": "JESSICA",
        "middle_name": "LEIGH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-04-01",
        "last_updated": "2020-04-01",
        "certification_date": "2020-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "WA",
            "license": "LL61041281",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Phong Bui
• Thi Diem My Bui
• Vickie Tamdoan Bui, DDS, MS
• Alissa Bulder, MA
• Tamara Bull
• Yadessa Bulte
• Katy Anne Buma, LMP
• Nancy Bumpus
• Heather Joy Bunce, LPN
• Cher Elizabeth Bunkley-Rea

• Speech-Language Pathologist in Vancouver, WA
• Providers in Vancouver, 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 1, 2020; 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.