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1003398363

NPI Code Detail

MEDICARE: CHRISTY LYNN MUSSER CCC-SLP

MEDICARE: CHRISTY LYNN MUSSER CCC-SLP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	015969	OR
2	235Z00000X	Speech-Language Pathologist	14201516

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	028067	OTHER	NY	NEW YORK BOARD OF EXAMINERS FOR SPEECH-LANGUAGE PATHOLOGY & AUDIOLOGY
2	015969	OTHER	OR	OREGON BOARD OF EXAMINERS FOR SPEECH-LANGUAGE PATHOLOGY & AUDIOLOGY
3	0441191	OTHER	OR	OR TEACHING LICENSE
4	61197688	OTHER	WA	WASHINGTON BOARD OF EXAMINERS FOR SPEECH-LANGUAGE PATHOLOGY & AUDIOLOGY
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	14201516	OTHER		ASHA CCC-SLP
7	2836966	OTHER	NY	NY TEACHING LICENSE: SPEECH & LANGUAGE DISABILITIES INITIAL
8	410054	OTHER	OR	OR ESOL

General Provider Information

NPI Number	:	1003398363
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTY LYNN MUSSER CCC-SLP

Provider Business Mailing Address
First Line	:	18404 SE 37TH CIR
Second Line	:
City	:	VANCOUVER
State	:	WA
Zip	:	98683-8240
Country	:	US
Telephone Number	:	714-369-7765
Fax Number	:

Provider Business Practice Location Address
First Line	:	5 CENTERPOINTE DR STE 400
Second Line	:
City	:	LAKE OSWEGO
State	:	OR
Zip	:	97035-8661
Country	:	US
Telephone Number	:	714-369-7765
Fax Number	:	503-406-2259

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/04/2018
Last Update Date	:	03/31/2023

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Directions to “ CHRISTY LYNN MUSSER CCC-SLP” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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