Individual provider Active NPI

Nichole Michelle Lessard, CCC-SLP

  • Speech-Language Pathologist
  • Renton, WA
National Provider Identifier
1578624565
Registry record updated Oct 27, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
LL00003505 Issued in WA
Practice address
3600 Lind Ave SW
Suite 160
Renton, WA 98057-4934
Phone
(425) 656-4215
NPI assigned
Dec 13, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X LL00003505 WA Primary

Addresses

Primary practice location

3600 Lind Ave SW
Suite 160
Renton, WA 98057-4934

Mailing address

16308 Tiger Mountain Rd SE
Issaquah, WA 98027-8339
Phone (425) 427-9628

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230516002066 WA Practitioner - Qualified Speech Language Pathologist 2163888280 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LL00003505WAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Multicare Health System CurrentSince Apr 19, 2023 Accepting new patients
Multicare Health System Current Accepting new patients
Multicare Health System Speech-Language Pathologist CurrentSince Apr 19, 2023 Accepting new patients

Locations

4700 Point Fosdick Dr
Ste 319
Gig Harbor, WA 98335
Phone (253) 530-8328

4700 Point Fosdick Dr
Ste 104
Gig Harbor, WA 98335
Phone (253) 459-7590

222 State Ave N
Kent, WA 98030
Phone (253) 372-7680

200 Lilly Rd NE
Ste C
Olympia, WA 98506
Phone (360) 918-8336

3600 Lind Ave SW
Ste 160
Renton, WA 98057
Phone (425) 656-4215

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1165968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193443200000",
    "number": "1578624565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16308 TIGER MOUNTAIN RD SE",
            "city": "ISSAQUAH",
            "state": "WA",
            "postal_code": "980278339",
            "telephone_number": "425-427-9628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3600 LIND AVE SW",
            "address_2": "SUITE 160",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980574934",
            "telephone_number": "425-656-4215"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LESSARD",
        "first_name": "NICHOLE",
        "middle_name": "MICHELLE",
        "credential": "CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-13",
        "last_updated": "2007-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "WA",
            "license": "LL00003505",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Renton, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2007; 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.