Amy Lynn Costanza-Smith, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

11842 Issued in OR

Practice address

707 SW Gaines St
Portland, OR 97239-2901

Phone

(800) 452-3563

NPI assigned

Sep 20, 2006

Last updated

Jul 8, 2007By the provider in NPPES

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)

Enrolled

State licenses

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1881791655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2135 SE MAIN ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972143839"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "707 SW GAINES ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972392901",
            "telephone_number": "800-452-3563"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COSTANZA-SMITH",
        "first_name": "AMY",
        "middle_name": "LYNN",
        "credential": "CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "OR",
            "license": "11842",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "295491",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Andrew Wellman Costa, DO
• Constance Lynn Costa, RN
• Landon James Costante, QMHA
• James D Costantino III, PA-C
• Mary Marcelle Costantino, MD
• Costco Wholesale Corporation
• Costco Wholesale Corporation (Costco Hearing Aid #2)
• Costco Wholesale Corporation (Costco Optical #2)
• Brianna Elizabeth-O'Mara Costello, PA-C
• Chanda J Costello, DMD

• Speech-Language Pathologist in Portland, OR
• Providers in Portland, OR by specialty
• Speech-Language Pathologist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.