NPIMap

Organization Active NPI

Island Speech Language & Rehabilitation, Inc.

  • Speech-Language Pathologist
  • Oak Harbor, WA
National Provider Identifier
1831339928
Registry record updated Mar 2, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
LL0003493 Issued in WA
Legal business name
ISLAND SPEECH LANGUAGE & REHABILITATION, INC.
Practice address
390 NE Midway Blvd
Suite B-101
Oak Harbor, WA 98277-2642
Phone
(360) 679-4211
Fax
(360) 279-2545
NPI assigned
Mar 2, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2009

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

Authorized official

Name
Jackie D. Long, M.A., CCC-SLPNPI 1821010356
Title
Owner
Phone
(360) 679-4211

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 LL0003493 WA Primary

Addresses

Primary practice location

390 NE Midway Blvd
Suite B-101
Oak Harbor, WA 98277-2642

Mailing address

390 NE Midway Blvd
Suite B-101
Oak Harbor, WA 98277-2642
Phone (360) 679-4211

National Provider Directory

National Provider Directory

Locations

390 NE Midway Blvd
Ste B101
Oak Harbor, WA 98277
Phone (360) 679-4211

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1235952000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1235952000000",
    "number": "1831339928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "390 NE MIDWAY BLVD",
            "address_2": "SUITE B-101",
            "city": "OAK HARBOR",
            "state": "WA",
            "postal_code": "982772642",
            "telephone_number": "360-679-4211",
            "fax_number": "360-279-2545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "390 NE MIDWAY BLVD",
            "address_2": "SUITE B-101",
            "city": "OAK HARBOR",
            "state": "WA",
            "postal_code": "982772642",
            "telephone_number": "360-679-4211",
            "fax_number": "360-279-2545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ISLAND SPEECH LANGUAGE & REHABILITATION, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-03-02",
        "last_updated": "2009-03-02",
        "status": "A",
        "authorized_official_last_name": "LONG",
        "authorized_official_first_name": "JACKIE",
        "authorized_official_middle_name": "D.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "360-679-4211",
        "authorized_official_credential": "M.A., CCC-SLP"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "WA",
            "license": "LL0003493",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oak Harbor, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2009; 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.