{
"Npi": {
"NPI": "1982482378",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "SUMMIT SPEECH THERAPY OF CENTRAL WASHINGTON, LLC",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": "6",
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "603 N ANDERSON ST",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "ELLENSBURG",
"MailingAddressStateName": "WA",
"MailingAddressPostalCode": "98926-3148",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "509-731-4018",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "700 E MOUNTAIN VIEW AVE STE 502",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "ELLENSBURG",
"PracticeLocationAddressStateName": "WA",
"PracticeLocationAddressPostalCode": "98926-4802",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "509-731-4018",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "09/18/2023",
"LastUpdateDate": "02/05/2026",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "SMITH",
"AuthorizedOfficialFirstName": "KELSEY",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "SPEECH THERAPIST/OWNER",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "MS, CCC-SLP",
"AuthorizedOfficialTelephoneNumber": "503-550-5684",
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "133V00000X",
"TaxonomyName": "Registered Dietitian",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "235Z00000X",
"TaxonomyName": "Speech-Language Pathologist",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": [
{
"HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
},
{
"HealthcareProviderTaxonomyGroupName": "193400000X SINGLE SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
}
]
}
}
}