Active NPI
Kolby Peek
- Speech-Language Pathologist
- Spanaway, WA
National Provider Identifier
1972347102
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- SI61568420
- Practice address
- 516 176TH St E
Spanaway, WA 98387-8335 - Phone
- (253) 800-2000
- NPI assigned
- Jun 21, 2024
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | SI61568420 | WA | Primary |
Addresses
Primary practice location
516 176TH St E
Spanaway, WA 98387-8335
Mailing address
1986 Valdemar PL
Bossier City, LA 71112-3912
Phone (318) 934-8932
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SI61568420 | WA | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1718928000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1718928000000",
"number": "1972347102",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1986 VALDEMAR PL",
"city": "BOSSIER CITY",
"state": "LA",
"postal_code": "711123912",
"telephone_number": "318-934-8932"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "516 176TH ST E",
"city": "SPANAWAY",
"state": "WA",
"postal_code": "983878335",
"telephone_number": "253-800-2000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PEEK",
"first_name": "KOLBY",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-06-21",
"last_updated": "2024-06-21",
"certification_date": "2024-06-21",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "WA",
"license": "SI61568420",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Spanaway, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.