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1669924502 NPI number — BRIGID MARIE-CROTTY PICCOLOTTI MS, CCC-SLP

NPI Number: 1669924502
Health Care Provider/Practitioner: BRIGID MARIE-CROTTY PICCOLOTTI MS, CCC-SLP

Information about “1669924502” NPI (BRIGID MARIE-CROTTY PICCOLOTTI MS, CCC-SLP) exists in 1669924502 in HTML format HTML  |  1669924502 in plain Text format TXT  |  1669924502 in PDF (Portable Document Format) PDF  |  1669924502 in an XML format XML  formats.

NPI Number : 1669924502 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1669924502",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "PICCOLOTTI",
    "FirstName": "BRIGID",
    "MiddleName": "MARIE-CROTTY",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "MS, CCC-SLP",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "CROTTY",
    "OtherFirstName": "BRIGID",
    "OtherMiddleName": "MARIE",
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": "MS, CF-SLP",
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "7005 NE OREGON ST",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "PORTLAND",
    "MailingAddressStateName": "OR",
    "MailingAddressPostalCode": "97213-5576",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "503-660-3231",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "16703 SE MCGILLIVRAY BLVD STE 170",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "VANCOUVER",
    "PracticeLocationAddressStateName": "WA",
    "PracticeLocationAddressPostalCode": "98683-4301",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "360-989-7347",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "10/26/2016",
    "LastUpdateDate": "09/10/2025",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "235Z00000X",
          "TaxonomyName": "Speech-Language Pathologist",
          "LicenseNumber": "015923",
          "LicenseNumberStateCode": "OR",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "235Z00000X",
          "TaxonomyName": "Speech-Language Pathologist",
          "LicenseNumber": "LL61470312",
          "LicenseNumberStateCode": "WA",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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