Richard Wallach, SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

LL 00003178 Issued in WA

Practice address

855 Aaron Dr
Lynden, WA 98264-9396

Phone

(360) 354-4434

Fax

(360) 354-5947

NPI assigned

Nov 22, 2010

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1290384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1290384000000",
    "number": "1659673762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1685 H ST",
            "address_2": "#990",
            "city": "BLAINE",
            "state": "WA",
            "postal_code": "982305110",
            "telephone_number": "360-306-1193"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "855 AARON DR",
            "city": "LYNDEN",
            "state": "WA",
            "postal_code": "982649396",
            "telephone_number": "360-354-4434",
            "fax_number": "360-354-5947"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACH",
        "first_name": "RICHARD",
        "credential": "SLP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-11-22",
        "last_updated": "2010-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "WA",
            "license": "LL 00003178",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Speech-Language Pathologist in Lynden, WA
• Providers in Lynden, 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 Nov 22, 2010; 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.