NPIMap

Organization Active NPI

Kelley a. Ford, Ms, CCC-SLP, PS

  • Speech-Language Pathologist
  • Lynnwood, WA
National Provider Identifier
1740594142
Registry record updated Jul 28, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
LL00003769 Issued in WA
Legal business name
KELLEY A. FORD, MS, CCC-SLP, PS
Practice address
19401 40TH Ave W
Suite 310
Lynnwood, WA 98036-4612
Phone
(425) 582-2473
Fax
(425) 582-2475
NPI assigned
Jul 28, 2010
Last updated
Jul 28, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2010

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

Authorized official

Name
Ms. Kelley A Ford, M.S., CCC-SLPNPI 1164598223
Title
Owner
Phone
(206) 954-1012

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language PathologistGroup: 193400000X SINGLE SPECIALTY GROUP 235Z00000X LL00003769 WA Primary

Addresses

Primary practice location

19401 40TH Ave W
Suite 310
Lynnwood, WA 98036-4612

Mailing address

19401 40TH Ave W
Suite 310
Lynnwood, WA 98036-4612
Phone (425) 582-2473

Other identifiers 1

IdentifierTypeStateIssuer
7140858MedicaidWA

National Provider Directory

National Provider Directory

Locations

19401 40th Ave W
Ste 310
Lynnwood, WA 98036
Phone (425) 582-2473

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1280275200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1280275200000",
    "number": "1740594142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19401 40TH AVE W",
            "address_2": "SUITE 310",
            "city": "LYNNWOOD",
            "state": "WA",
            "postal_code": "980364612",
            "telephone_number": "425-582-2473",
            "fax_number": "425-582-2475"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19401 40TH AVE W",
            "address_2": "SUITE 310",
            "city": "LYNNWOOD",
            "state": "WA",
            "postal_code": "980364612",
            "telephone_number": "425-582-2473",
            "fax_number": "425-582-2475"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KELLEY A. FORD, MS, CCC-SLP, PS",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-07-28",
        "last_updated": "2010-07-28",
        "status": "A",
        "authorized_official_last_name": "FORD",
        "authorized_official_first_name": "KELLEY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "206-954-1012",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "M.S., CCC-SLP"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "WA",
            "license": "LL00003769",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7140858",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lynnwood, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 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.