NPIMap

Organization Active NPI

Cleartalk Speech and Language Therapy, LLC

Doing business as Columba Pediatric Therapy

  • Speech-Language Pathologist
  • Vancouver, WA
National Provider Identifier
1972013977
Registry record updated May 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
Legal business name
CLEARTALK SPEECH AND LANGUAGE THERAPY, LLC
Doing business as
Columba Pediatric Therapy
Practice address
16703 SE McGillivray Blvd Ste 170
Vancouver, WA 98683-4301
Phone
(360) 989-7347
Fax
(888) 974-0252
NPI assigned
Oct 4, 2017
Last updated
May 12, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 12, 2022

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

Authorized official

Name
Kendra Holloway, SLPNPI 1275936551
Title
Provider
Phone
(503) 567-6326

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X NU
Speech-Language Pathologist 235Z00000X NU Primary

Addresses

Primary practice location

16703 SE McGillivray Blvd Ste 170
Vancouver, WA 98683-4301

Mailing address

17920 NE 198TH CT
Brush Prairie, WA 98606-8806
Phone (503) 567-6326

Other practice location 1

6511 E 18th St
Vancouver, WA 98661-6869
Phone (503) 567-6326

Other identifiers 1

IdentifierTypeStateIssuer
2081962MedicaidWA

Other names 1

  • Columba Pediatric Therapy Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL Fax Other

National Provider Directory

National Provider Directory

Locations

15640 NE Fourth Plain Blvd
Ste 106
Vancouver, WA 98682
Phone (360) 550-9745

16703 SE McGillivray Blvd
Ste 170
Vancouver, WA 98683
Phone (360) 989-7347

Practitioners & affiliated clinicians

Practitioners 27

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 27

NPI Registry JSON

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

{
    "created_epoch": "1507075200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1652313600000",
    "number": "1972013977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17920 NE 198TH CT",
            "city": "BRUSH PRAIRIE",
            "state": "WA",
            "postal_code": "986068806",
            "telephone_number": "503-567-6326",
            "fax_number": "888-974-0252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16703 SE MCGILLIVRAY BLVD STE 170",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986834301",
            "telephone_number": "360-989-7347",
            "fax_number": "888-974-0252"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6511 E 18th St",
            "address_purpose": "LOCATION",
            "city": "Vancouver",
            "state": "WA",
            "postal_code": "986616869",
            "country_code": "US",
            "telephone_number": "503-567-6326",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CLEARTALK SPEECH AND LANGUAGE THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-10-04",
        "last_updated": "2022-05-12",
        "certification_date": "2021-11-12",
        "status": "A",
        "authorized_official_last_name": "HOLLOWAY",
        "authorized_official_first_name": "KENDRA",
        "authorized_official_title_or_position": "PROVIDER",
        "authorized_official_telephone_number": "503-567-6326",
        "authorized_official_credential": "SLP"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2081962",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Fax",
            "affiliation": "N",
            "endpointDescription": "Fax",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "Sending/Receiving Information",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Fax",
            "address_1": "16703 SE McGillivray Blvd Ste 170",
            "city": "Vancouver",
            "state": "WA",
            "country_code": "US",
            "postal_code": "986834301",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Columba Pediatric Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Vancouver, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2022; 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.