Marilea S Brock, MS, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

LL00004266 Issued in WA

Practice address

3305 Main St Ste 200
Vancouver, WA 98663-2250

Phone

(360) 798-8653

Fax

(360) 326-2277

NPI assigned

Nov 28, 2006

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

Credentials

Master of Science

State licenses

Practice roles

Locations

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

• Communication Connection NW

  • Speech-Language Pathologist
  • Vancouver, WA
  • NPI 1306312558
  NPD Authorized official
• Legacy Salmon Creek Hospital

  • General Acute Care Hospital
  • Vancouver, WA
  • NPI 1700809829
  NPD (past)

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

{
    "created_epoch": "1164672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539561600000",
    "number": "1801962840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3305 MAIN ST STE 200",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986632250",
            "telephone_number": "360-798-8653",
            "fax_number": "360-326-2277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3305 MAIN ST STE 200",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986632250",
            "telephone_number": "360-798-8653",
            "fax_number": "360-326-2277"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2121 NE 139th St",
            "address_purpose": "LOCATION",
            "city": "Vancouver",
            "state": "WA",
            "postal_code": "986862316",
            "country_code": "US",
            "telephone_number": "360-487-1777",
            "fax_number": "360-487-1779",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BROCK",
        "first_name": "MARILEA",
        "middle_name": "S",
        "name_prefix": "Mrs.",
        "credential": "MS, CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-28",
        "last_updated": "2018-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "WA",
            "license": "LL00004266",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ASHA NUMBER",
            "identifier": "12096728",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kyle Brittain, EMT-BASIC
• Madison Jo Brixey, PT, DPT
• Coleen Broad, CERTIFICATE
• Holly Brock, PA
• Letha Evelyn Brock
• Heidi Brockman-Astrue, LPC, LMHC, MAC
• Michell Brockman
• Patricia Lynn Brockman, MOT/L
• Samantha Josefine Moana Brodehl
• Suzanne Brody

• Speech-Language Pathologist in Vancouver, WA
• Providers in Vancouver, 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 Oct 15, 2018; 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.