Kristin Lucille Church, MS-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

LL60647821 Issued in WA

Practice address

1850 Boyer Ave E
Seattle, WA 98112-2922

Phone

(206) 325-8477

Fax

(206) 323-1385

NPI assigned

Jun 23, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Kristin Lucille Mink Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Boyer Children's Clinic

  • Local Education Agency (LEA)
  • Seattle, WA
  • NPI 1760526388
  NPD (past)

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

{
    "created_epoch": "1466640000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1466640000000",
    "number": "1992156657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1850 BOYER AVE E",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981122922",
            "telephone_number": "206-325-8477",
            "fax_number": "206-323-1385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1850 BOYER AVE E",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981122922",
            "telephone_number": "206-325-8477",
            "fax_number": "206-323-1385"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHURCH",
        "first_name": "KRISTIN",
        "middle_name": "LUCILLE",
        "credential": "MS-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-06-23",
        "last_updated": "2016-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "WA",
            "license": "LL60647821",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7020464",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTIN",
            "last_name": "MINK",
            "middle_name": "LUCILLE",
            "credential": "MS-SLP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Alicia Diane Chunn
• Asfaw Chura
• Craig Church
• Dianna Church, DPT
• Julie A. Church, RD
• Laura Elizabeth Church
• Lili L Church
• Melanie Church
• Sarah Church, RN
• Ayesha Asleke Churchill, LPN

• Speech-Language Pathologist in Seattle, WA
• Providers in Seattle, 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 Jun 23, 2016; 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.