Individual provider Active NPI

Aubray Jennine Magnusson, M.S. CCC-SLP

  • Speech-Language Pathologist
  • Tukwila, WA
National Provider Identifier
1619640919
Registry record updated Jul 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
Practice address
13925 Interurban Ave S Ste 120
Tukwila, WA 98168-5718
Phone
(206) 948-0096
NPI assigned
Aug 1, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 26, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language PathologistGroup: 193400000X SINGLE SPECIALTY GROUP 235Z00000X Primary

Addresses

Primary practice location

13925 Interurban Ave S Ste 120
Tukwila, WA 98168-5718

Mailing address

13925 Interurban Ave S Ste 120
Tukwila, WA 98168-5718

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

Practice roles

OrganizationSpecialtyStatusNew patients
Sky Bridge Therapies LLC Speech-Language Pathologist PastSince Aug 1, 2021 Accepting new patients
Cole Sky Therapy PLLC PastSince Aug 28, 2022 Accepting new patients

Organizations & group practices 2

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": "1627776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690329600000",
    "number": "1619640919",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13925 INTERURBAN AVE S STE 120",
            "city": "TUKWILA",
            "state": "WA",
            "postal_code": "981685718"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13925 INTERURBAN AVE S STE 120",
            "city": "TUKWILA",
            "state": "WA",
            "postal_code": "981685718",
            "telephone_number": "206-948-0096"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAGNUSSON",
        "first_name": "AUBRAY",
        "middle_name": "JENNINE",
        "credential": "M.S. CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-08-01",
        "last_updated": "2023-07-26",
        "certification_date": "2023-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tukwila, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2023; 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.