Alyssa Staples, M.S., CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

LL61089912 Issued in WA

Practice address

112 E Spencer Lake Rd
Shelton, WA 98584-7307

Phone

(661) 313-0854

NPI assigned

Oct 7, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1602028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602028800000",
    "number": "1821695297",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2734 STRATFORD LN SW APT 2215",
            "city": "TUMWATER",
            "state": "WA",
            "postal_code": "985126009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 E SPENCER LAKE RD",
            "city": "SHELTON",
            "state": "WA",
            "postal_code": "985847307",
            "telephone_number": "661-313-0854"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STAPLES",
        "first_name": "ALYSSA",
        "credential": "M.S., CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-10-07",
        "last_updated": "2020-10-07",
        "certification_date": "2020-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "WA",
            "license": "LL61089912",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Squaxin Island Medical Encounter
• Squaxin Island Tribe
• Squaxin Island Tribe
• Squaxin Island Tribe
• Paula Maxine Stack, RN
• Darcy Lynne Staples
• James Stauffer, PA-C
• Marjorie Steed, OT
• Wendy Lynn Steinberg, COTA
• Steven Bowers DDS, PLLC

• Speech-Language Pathologist in Shelton, WA
• Providers in Shelton, 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 7, 2020; 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.