NPIMap

Organization Active NPI

Childhood Speech & Language

  • Speech-Language Pathologist
  • Redmond, WA
National Provider Identifier
1760520613
Registry record updated Apr 25, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
LL00002785 Issued in WA
Legal business name
CHILDHOOD SPEECH & LANGUAGE
Practice address
2721 152ND Ave NE
Redmond, WA 98052-5552
Phone
(425) 867-0475
NPI assigned
Feb 2, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2011

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

Authorized official

Name
Ryan J Conley, CCC-SLPNPI 1134349327
Title
Director
Phone
(425) 867-0475

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 LL00002785 WA Primary

Addresses

Primary practice location

2721 152ND Ave NE
Redmond, WA 98052-5552

Mailing address

2721 152ND Ave NE
Redmond, WA 98052-5552

National Provider Directory

National Provider Directory

Locations

2721 152nd Ave NE
Redmond, WA 98052
Phone (206) 412-6037

Practitioners & affiliated clinicians

Practitioners 1

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": "1170374400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1303689600000",
    "number": "1760520613",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2721 152ND AVE NE",
            "city": "REDMOND",
            "state": "WA",
            "postal_code": "980525552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2721 152ND AVE NE",
            "city": "REDMOND",
            "state": "WA",
            "postal_code": "980525552",
            "telephone_number": "425-867-0475"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHILDHOOD SPEECH & LANGUAGE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-02",
        "last_updated": "2011-04-25",
        "status": "A",
        "authorized_official_last_name": "CONLEY",
        "authorized_official_first_name": "RYAN",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "425-867-0475",
        "authorized_official_credential": "CCC-SLP"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "WA",
            "license": "LL00002785",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Redmond, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2011; 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.