Trina Renee Wilson, SPEECH LANGUAGE PATH

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

12754 Issued in OR

Practice address

201 SE Tide Ave
Lincoln City, OR 97367-3058

Phone

(509) 868-8944

NPI assigned

Jul 31, 2017

Last updated

Jul 31, 2017By 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

• Trina Renee Branch Former name

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": "1501459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1501459200000",
    "number": "1720502909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1271 NE HIGHWAY 99W # 124",
            "city": "MCMINNVILLE",
            "state": "OR",
            "postal_code": "971282720",
            "telephone_number": "509-868-8944"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 SE TIDE AVE",
            "city": "LINCOLN CITY",
            "state": "OR",
            "postal_code": "973673058",
            "telephone_number": "509-868-8944"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "TRINA",
        "middle_name": "RENEE",
        "credential": "SPEECH LANGUAGE PATH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-07-31",
        "last_updated": "2017-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "OR",
            "license": "12754",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TRINA",
            "last_name": "BRANCH",
            "middle_name": "RENEE",
            "credential": "SPEECH LANGUAGE PATH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Linda K Williams
• Michael Derek Williams, DO
• Aimy Marie Wilson
• Elaina Wilson, RNFA
• Robert J Wilson, LMT
• Nicolai Wohns, M.D.
• Roman Wolansky, DC
• Harrison Wood, PHARMD
• Michael Wright
• Yevette Wright

• Speech-Language Pathologist in Lincoln City, OR
• Providers in Lincoln City, OR by specialty
• Speech-Language Pathologist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2017; 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.