Kimberly Dykstra, SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

LL60805891 Issued in WA

Practice address

2121 NE 139TH St Ste 200
Vancouver, WA 98686

Phone

(503) 525-7694

NPI assigned

Aug 13, 2015

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1439424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534982400000",
    "number": "1841666880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1650 NW NAITO PKWY STE 185",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972092535",
            "telephone_number": "503-525-7694",
            "fax_number": "503-525-7652"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2121 NE 139TH ST STE 200",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "98686",
            "telephone_number": "503-525-7694"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DYKSTRA",
        "first_name": "KIMBERLY",
        "credential": "SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-13",
        "last_updated": "2018-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "WA",
            "license": "LL60805891",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Keelin Dyer
• Heidi Hristine Dyk, BS
• Matthew James Dykema, DPT
• Paula Fries Dykema, DPT
• Jonathan Dykstra, MD
• Dynamic Arm and Hand Therapy PLLC
• Dynamic Foot and Ankle LLC
• Douglas Dziamba
• Suzana Dzyuba
• E Group Wa LLC

• 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 Aug 23, 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.