Individual provider Active NPI

Megan Anne Brandkamp, CCC-SLP

  • Speech-Language Pathologist
  • Tacoma, WA
National Provider Identifier
1609313683
Registry record updated Jan 27, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
LL60637803 Issued in WA
Practice address
535 Dock St
#104
Tacoma, WA 98402-4614
Phone
(253) 874-9300
Fax
(206) 374-2533
NPI assigned
Jan 27, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 27, 2017

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 LL60637803 WA Primary

Addresses

Primary practice location

535 Dock St
#104
Tacoma, WA 98402-4614

Mailing address

535 Dock St
#104
Tacoma, WA 98402-4614
Phone (253) 874-9300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
LL60637803WAMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1485475200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485475200000",
    "number": "1609313683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "535 DOCK ST",
            "address_2": "#104",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984024614",
            "telephone_number": "253-874-9300",
            "fax_number": "206-374-2533"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "535 DOCK ST",
            "address_2": "#104",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984024614",
            "telephone_number": "253-874-9300",
            "fax_number": "206-374-2533"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRANDKAMP",
        "first_name": "MEGAN",
        "middle_name": "ANNE",
        "name_prefix": "Miss",
        "credential": "CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-01-27",
        "last_updated": "2017-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "WA",
            "license": "LL60637803",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tacoma, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2017; 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.