Kathleen Patricia Clutter, M.A.

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

LL00004721 Issued in WA

Practice address

19021 120TH Ave NE Ste 102
Bothell, WA 98011-9511

Phone

(425) 486-7710

NPI assigned

Feb 5, 2007

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

Other names 1

• Kathleen Patricia Kirkwood Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

Practice roles

Locations

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.

• Children'S Therapy of Woodinville

  • Pediatric Occupational Therapist
  • Bothell, WA
  • NPI 1558440198

  Speech-Language Pathologist

  NPD Authorized official
• Kids in Motion, Inc.

  • Occupational Therapist
  • Woodinville, WA
  • NPI 1427107259
  NPD (past)

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

{
    "created_epoch": "1170633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652140800000",
    "number": "1710026901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19021 120TH AVE NE STE 102",
            "city": "BOTHELL",
            "state": "WA",
            "postal_code": "980119511",
            "telephone_number": "425-486-7710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19021 120TH AVE NE STE 102",
            "city": "BOTHELL",
            "state": "WA",
            "postal_code": "980119511",
            "telephone_number": "425-486-7710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLUTTER",
        "first_name": "KATHLEEN",
        "middle_name": "PATRICIA",
        "credential": "M.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-05",
        "last_updated": "2022-05-10",
        "certification_date": "2022-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "WA",
            "license": "SI00004315",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "WA",
            "license": "LL00004721",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHLEEN",
            "last_name": "KIRKWOOD",
            "middle_name": "PATRICIA",
            "credential": "M.A.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Leslie Cisneros
• City of Bothell
• James Daniel Clark, DNP, APRN, FNP-BC
• Thomas J Clark, LMT
• Roxanne Clemence, LMP, LMT
• Alice J Coad, ARNP
• Wendy Coard, MD
• Niecole Monisha Coder, DDS
• Lucas Eugene Cohen
• Carin Colantes

• Speech-Language Pathologist in Bothell, WA
• Providers in Bothell, 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 10, 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.