Blue Jay Speech & Language Therapy Services, LLC

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

Legal business name

BLUE JAY SPEECH & LANGUAGE THERAPY SERVICES, LLC

Doing business as

Blue Jay Speech

Practice address

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

Phone

(360) 314-2252

NPI assigned

Jun 28, 2020

Last updated

Jun 28, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jessica Bullock, CCC-SLPNPI 1477182525

Title

Owner

Phone

(360) 314-2252

Specialties & licenses 1

Addresses

Other names 1

• Blue Jay Speech Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jessica Leigh Bullock

  • Speech-Language Pathologist
  • Vancouver, WA
  • NPI 1477182525
  NPD Authorized official

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

{
    "created_epoch": "1593302400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1593302400000",
    "number": "1538786306",
    "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": "360-314-2252"
        },
        {
            "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": "360-314-2252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUE JAY SPEECH & LANGUAGE THERAPY SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-28",
        "last_updated": "2020-06-28",
        "certification_date": "2020-06-28",
        "status": "A",
        "authorized_official_last_name": "BULLOCK",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "360-314-2252",
        "authorized_official_credential": "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": [
        {
            "organization_name": "Blue Jay Speech",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• 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 Jun 28, 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.