Jessica Lee Larson, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

60779490 Issued in WA

Practice address

4183 Sunnyslope Rd SW
Port Orchard, WA 98367-7677

Phone

(360) 443-3503

NPI assigned

Nov 7, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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": "1510012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1510012800000",
    "number": "1770096265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9160 KRISTI CT NW",
            "city": "BREMERTON",
            "state": "WA",
            "postal_code": "983119010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4183 SUNNYSLOPE RD SW",
            "city": "PORT ORCHARD",
            "state": "WA",
            "postal_code": "983677677",
            "telephone_number": "360-443-3503"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARSON",
        "first_name": "JESSICA",
        "middle_name": "LEE",
        "credential": "CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-11-07",
        "last_updated": "2017-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "WA",
            "license": "60779490",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICAN SPEECH-LANGUAGE-HEARING ASSOCIATION (ASHA)",
            "identifier": "14074866",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sharyn Lane
• Amber Marie Lapolla, PTA
• Anita L Larae, LMHC
• Dena Larsen, DPT
• Mallory Larson-Burns
• Gerard V Lasalle, MD
• Jensen Lau, RPH
• Crystal R Laub, LMP
• Rhonda E. Law, PT
• Douglas M Lawrence, CDP

• Speech-Language Pathologist in Port Orchard, WA
• Providers in Port Orchard, WA by specialty
• Speech-Language Pathologist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 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.