Individual provider Active NPI

Brittany Ann Olsen-Boblitt, M.S., CCC-SLP

  • Speech-Language Pathologist
  • Clinton, WA
National Provider Identifier
1760782825
Registry record updated Jun 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
LL60185516 Issued in WA
Practice address
6210 Windfall Rd
Clinton, WA 98236-8613
Phone
(206) 409-6639
Fax
(360) 641-7322
NPI assigned
Oct 23, 2010
Last updated
Jun 28, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 28, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X LL60185516 WA Primary

Addresses

Primary practice location

6210 Windfall Rd
Clinton, WA 98236-8613

Mailing address

6210 Windfall Rd
Clinton, WA 98236-8613
Phone (206) 409-6639

Other practice location 1

12115 100th Ave NE
Kirkland, WA 98034-6743
Phone (206) 409-6639

Other identifiers 1

IdentifierTypeStateIssuer
2135360MedicaidWA

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)
Not enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
LL60185516WAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Brittany Olsen-Boblitt, Ms, CCC-SLP, LLC Speech-Language Pathologist CurrentSince Sep 1, 2019 Accepting new patients

Locations

6442 Central Ave
Ste C
Clinton, WA 98236

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1287792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656374400000",
    "number": "1760782825",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6210 WINDFALL RD",
            "city": "CLINTON",
            "state": "WA",
            "postal_code": "982368613",
            "telephone_number": "206-409-6639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6210 WINDFALL RD",
            "city": "CLINTON",
            "state": "WA",
            "postal_code": "982368613",
            "telephone_number": "206-409-6639",
            "fax_number": "360-641-7322"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12115 100th Ave NE",
            "address_purpose": "LOCATION",
            "city": "Kirkland",
            "state": "WA",
            "postal_code": "980346743",
            "country_code": "US",
            "telephone_number": "206-409-6639",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OLSEN-BOBLITT",
        "first_name": "BRITTANY",
        "middle_name": "ANN",
        "credential": "M.S., CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-10-23",
        "last_updated": "2022-06-28",
        "certification_date": "2022-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "WA",
            "license": "LL60185516",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2135360",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clinton, WA

Sources for this page

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