Active NPI
Sally Johnston, M.S., CCC-SLP
- Speech-Language Pathologist
- Moscow, ID
National Provider Identifier
1619024924
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- LL00002773
- Practice address
- 905 N Meadow St
Moscow, ID 83843-9584 - Phone
- (208) 882-3381
- NPI assigned
- Jan 5, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | LL00002773 | WA | Primary |
Addresses
Primary practice location
905 N Meadow St
Moscow, ID 83843-9584
Mailing address
1620 SW Summit CT.
Pullman, WA 99163
Phone (509) 332-5106
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01108824 | Other | ASHA MEMBER | |
| LL00002773 | Other | WA | LISCENSE SPEECH-LANGUAGE |
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LL00002773 | WA | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167955200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1619024924",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1620 SW SUMMIT CT.",
"city": "PULLMAN",
"state": "WA",
"postal_code": "99163",
"telephone_number": "509-332-5106"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "905 N MEADOW ST",
"city": "MOSCOW",
"state": "ID",
"postal_code": "838439584",
"telephone_number": "208-882-3381"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSTON",
"first_name": "SALLY",
"name_prefix": "Ms.",
"credential": "M.S., CCC-SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-05",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "WA",
"license": "LL00002773",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ASHA MEMBER",
"identifier": "01108824",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LISCENSE SPEECH-LANGUAGE",
"identifier": "LL00002773",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Moscow, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.