Active NPI
Kasey Moosman
- Speech-Language Pathologist
- Deer Park, WA
National Provider Identifier
1750754495
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- LL 60461644
- Practice address
- 702 S Park St
Deer Park, WA 99006-7025 - Phone
- (509) 276-2005
- NPI assigned
- Nov 3, 2015
- Last updated
- Nov 3, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | LL 60461644 | WA | Primary |
Addresses
Primary practice location
702 S Park St
Deer Park, WA 99006-7025
Mailing address
702 S Park St
Deer Park, WA 99006-7025
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LL 60461644 | WA | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1446508800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1446508800000",
"number": "1750754495",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "702 S PARK ST",
"city": "DEER PARK",
"state": "WA",
"postal_code": "990067025"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "702 S PARK ST",
"city": "DEER PARK",
"state": "WA",
"postal_code": "990067025",
"telephone_number": "509-276-2005"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOOSMAN",
"first_name": "KASEY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-11-03",
"last_updated": "2015-11-03",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "WA",
"license": "LL 60461644",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Deer Park, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.