Alyssa Peterson

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

Practice address

8301 161St Ave NE Ste 208
Redmond, WA 98052-3858

Phone

(425) 882-4347

NPI assigned

May 2, 2022

Last updated

May 2, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Alyssa Bathurst Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1651449600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651449600000",
    "number": "1659016897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8301 161ST AVE NE STE 208",
            "city": "REDMOND",
            "state": "WA",
            "postal_code": "980523858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8301 161ST AVE NE STE 208",
            "city": "REDMOND",
            "state": "WA",
            "postal_code": "980523858",
            "telephone_number": "425-882-4347"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "ALYSSA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-05-02",
        "last_updated": "2022-05-02",
        "certification_date": "2022-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALYSSA",
            "last_name": "BATHURST",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Performance Modalities Inc (Performance Home Medical)
• Joe Francis Pergamo, PHYSICAL THERAPIST
• Crystal Ann Periot, DPT
• Ashley Perrin
• Taycee Peterson-Diehl
• Athena Peterson, LMHC
• John M Petrich, M.D.
• James H Petrin, MD
• Evelyn Pham, OD
• Minh H Pham, L.AC.

• Speech-Language Pathologist in Redmond, WA
• Providers in Redmond, 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 May 2, 2022; 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.