Rielly Davis, SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SI61194426 Issued in WA

Practice address

801 Trail Rd
Sedro Woolley, WA 98284-9302

Phone

(360) 855-3036

NPI assigned

Sep 11, 2018

Reactivated

Sep 30, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

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": "1536624000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632960000000",
    "number": "1699258129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12229 MAPLE CREST DR",
            "city": "BURLINGTON",
            "state": "WA",
            "postal_code": "982333568",
            "telephone_number": "360-540-2303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 TRAIL RD",
            "city": "SEDRO WOOLLEY",
            "state": "WA",
            "postal_code": "982849302",
            "telephone_number": "360-855-3036"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "RIELLY",
        "credential": "SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-11",
        "last_updated": "2021-09-30",
        "certification_date": "2021-09-30",
        "deactivation_date": "2021-09-08",
        "reactivation_date": "2021-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2355S0801X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Speech-Language Assistant",
            "state": "WA",
            "license": "60868541",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "WA",
            "license": "SI61194426",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Zechariah Daniels, HIS
• Serena Danville
• Lawrence Alan Darienzo, MA
• Damara Lashay Davis, MA
• Nicole Roberta Davis
• Jennifer Leanne Dawes, M.P.T.
• Todd William Dawes, M.P.T.
• Audrey Elizabeth Dawson
• Briana Marie Day
• Romeo D De la Pena, ND, PHD, REFLEXOLOGY

• Speech-Language Pathologist in Sedro Woolley, WA
• Providers in Sedro Woolley, 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 Sep 30, 2021; 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.