Individual provider Active NPI

Thomas Aaron Retsema, MA, CCC-SLP

  • Speech-Language Pathologist
  • Woodburn, OR
National Provider Identifier
1902766892
Registry record updated Nov 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
015471 Issued in OR
Practice address
1390 Meridian Dr
Woodburn, OR 97071-9668
Phone
(503) 981-2854
NPI assigned
Nov 13, 2025
Last updated
Nov 13, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 015471 OR Primary

Addresses

Primary practice location

1390 Meridian Dr
Woodburn, OR 97071-9668

Mailing address

816 E Hemlock LN
Newberg, OR 97132-1121
Phone (503) 550-1323

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
015471ORMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1762992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762992000000",
    "number": "1902766892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "816 E HEMLOCK LN",
            "city": "NEWBERG",
            "state": "OR",
            "postal_code": "971321121",
            "telephone_number": "503-550-1323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1390 MERIDIAN DR",
            "city": "WOODBURN",
            "state": "OR",
            "postal_code": "970719668",
            "telephone_number": "503-981-2854"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RETSEMA",
        "first_name": "THOMAS",
        "middle_name": "AARON",
        "name_prefix": "Mr.",
        "credential": "MA, CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-11-13",
        "last_updated": "2025-11-13",
        "certification_date": "2025-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "OR",
            "license": "015471",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodburn, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2025; 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.