Risa Itani Ms CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

Legal business name

RISA ITANI MS CCC-SLP

Practice address

235 SE Davis Ave
Bend, OR 97702-1333

Phone

(541) 241-6153

NPI assigned

Oct 29, 2019

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Risa Itani, MS CCC-SLP

Title

Sole Member/Manager

Phone

(352) 209-6494

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1572307200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1572480000000",
    "number": "1477197994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1240 SW 16TH ST",
            "city": "REDMOND",
            "state": "OR",
            "postal_code": "977562906",
            "telephone_number": "352-209-6494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "235 SE DAVIS AVE",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977021333",
            "telephone_number": "541-241-6153"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RISA ITANI MS CCC-SLP",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-29",
        "last_updated": "2019-10-31",
        "status": "A",
        "authorized_official_last_name": "ITANI",
        "authorized_official_first_name": "RISA",
        "authorized_official_title_or_position": "SOLE MEMBER/MANAGER",
        "authorized_official_telephone_number": "352-209-6494",
        "authorized_official_credential": "MS CCC-SLP"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2019; 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.