KELLY SOUKUP (NPI# 1891049615) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1891049615 |
| Entity Type | Individual |
| Full Name | KELLY SOUKUP |
| Practice Address |
15675 Ambaum Blvd Sw Highline School District Burien WA 98166-2523 |
| Practice Telephone | 2064332125 |
| Enumeration Date | 2012-10-31 |
| Last Update Date | 2012-10-31 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 235Z00000X | Speech-Language Pathologist | Speech, Language and Hearing Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669419610 | Kelly J Soukup | Physical Therapist | 1000 W 140th St, Suite 202, Burnsville, MN 55337-4480 | 2006-05-31 |
| Street Address |
15675 AMBAUM BLVD SW HIGHLINE SCHOOL DISTRICT |
| City | BURIEN |
| State | WA |
| Zip Code | 98166-2523 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710099478 | Highline School District | Local Education Agency (LEA) | 15675 Ambaum Blvd Sw, Burien, WA 98166-2523 | 2006-08-31 |
| 1023617636 | Gillian Marie Grimsrud | Occupational Therapist | 15675 Ambaum Blvd Sw, Burien, WA 98166-2523 | 2020-10-23 |
| 1154920973 | Littlepage Taliaferro | Occupational Therapist | 15675 Ambaum Blvd Sw, Burien, WA 98166-2523 | 2020-10-22 |
| 1700408952 | Jeanine Totten | Registered Nurse | 15675 Ambaum Blvd Sw, Burien, WA 98166-2523 | 2020-05-11 |
| 1861032872 | Christina Lajoie | Registered Nurse | 15675 Ambaum Blvd Sw, Burien, WA 98166-2523 | 2020-01-08 |
| 1720639651 | Olivia Antunes Cukierman | Registered Nurse | 15675 Ambaum Blvd Sw, Burien, WA 98166-2523 | 2019-09-23 |
| 1265082572 | Madeline Patten | Registered Nurse | 15675 Ambaum Blvd Sw, Burien, WA 98166-2523 | 2019-09-18 |
| 1205483153 | Roxanne Caple | Registered Nurse | 15675 Ambaum Blvd Sw, Burien, WA 98166-2523 | 2019-08-23 |
| 1922655943 | Soo Jee Lee | Licensed Practical Nurse | 15675 Ambaum Blvd Sw, Burien, WA 98166-2523 | 2019-08-23 |
| 1891342820 | Shina Oh | Licensed Practical Nurse | 15675 Ambaum Blvd Sw, Burien, WA 98166-2523 | 2019-08-23 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508341488 | Robert James Woodland Sr. | Counselor | 1210 Sw 136th St., Burien, WA 98166 | 2018-09-26 |
| 1215467329 | Amy Elizabeth Castillo | Massage Therapist | 1204 Sw 168th St, Normandy Park, WA 98166 | 2017-06-13 |
| 1053856070 | Michael David Blackledge | Physical Therapist | 15811 Ambaum Blvd Sw Ste 140, Burien, WA 98166 | 2016-12-29 |
| 1114372232 | Maris Gibson | Massage Therapist | 801 S.w. 150thst, #110, Burien, WA 98166 | 2016-04-26 |
| 1649642992 | Navos | Community/Behavioral Health | 31408 28th Ave South, 1201 Sw 136th Street, Burien, WA 98166 | 2015-10-27 |
| 1154790798 | Han Nguyen | Chiropractor | 15811 Ambaum Blvd Sw Suite 110, Burien, WA 98166 | 2015-09-24 |
| 1497163778 | Maria Garvey-caruso | Physical Therapist | 1511 Ambaum Blvd South West, Suite 140, Burien, WA 98166 | 2014-07-30 |
| 1427495274 | Mohammed Nayeemuddin | Internal Medicine | 16259 Sylvester Rd Sw Ste 404, Burien, WA 98166 | 2013-06-03 |
| 1023362753 | Donna Shaman | Occupational Therapist | 15675 Ambaum Blvd, Burien, WA 98166 | 2012-11-02 |
| 1366707010 | Tracy C Saephanh | Pharmacy Technician | 14901 4th Ave Sw Ste 100, Burien, WA 98166 | 2012-07-09 |
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| Taxonomy Code | 235Z00000X |
| Grouping | Speech, Language and Hearing Service Providers |
| Classification | Speech-Language Pathologist |
| The speech-language pathologist is the professional who engages in clinical services, prevention, advocacy, education, administration, and research in the areas of communication and swallowing across the life span from infancy through geriatrics. Speech-language pathologists address typical and atypical impairments and disorders related to communication and swallowing in the areas of speech sound production, resonance, voice, fluency, language (comprehension and expression), cognition, and feeding and swallowing. |
| Notes: "Scope of Practice in Speech-Language Pathology", American Speech-Language-Hearing Association, 2013. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750635439 | Barbara Lynn Bryant | Speech-Language Pathologist | 2725 Sw 116th St, Burien, WA 98146-3414 | 2012-11-02 |
| 1053665737 | Rachelle Canavas | Speech-Language Pathologist | 16201 16th Ave Sw, Burien, WA 98166-2859 | 2012-11-02 |
| 1487852448 | Sasha Ernst Torkildson | Speech-Language Pathologist | 11621 29th Ave Sw, Burien, WA 98146-2416 | 2007-07-10 |
| 1609489194 | Emily Mcquarrie | Speech-Language Pathologist | 127 Sw 156th St, Burien, WA 98166-2515 | 2020-08-25 |
| 1821643446 | Caitlin Mae Harris | Speech-Language Pathologist | 127 Sw 156th St, Burien, WA 98166-2515 | 2019-08-09 |
| 1790203065 | Breanne Marie Toney | Speech-Language Pathologist | 127 Sw 156th St, Burien, WA 98166-2515 | 2017-09-06 |
| 1194104620 | Mallory Puentes | Speech-Language Pathologist | 1031 Sw 130th St, Burien, WA 98146-3132 | 2015-05-29 |
| 1083959704 | Ron Al Winter | Speech-Language Pathologist | 15675 Ambaum Blvd Sw, Burien, WA 98166-2523 | 2012-12-06 |
| 1639414568 | Cheryl Sack | Speech-Language Pathologist | 15675 Ambaum Blvd Sw, Burien, WA 98166-2523 | 2012-12-04 |
| 1609111681 | Krystyna Wrobel | Speech-Language Pathologist | 15675 Ambaum Blvd Sw, Burien, WA 98166-2523 | 2012-12-03 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.