Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Kimberly Anne Johnson, MS, CCC-SLP

Individual provider Speech-Language Pathologist · NPI 1114531480

Kimberly Anne Johnson, MS, CCC-SLP is a Speech-Language Pathologist in Bend, Oregon. Licensed in Idaho and Oregon. Registered with an NPI since 2020.

Licensed in
ID, OR
In the registry since
2020
Specialties on file
3
What do these letters mean?
MS — Master of Science
A graduate science degree.
CCC-SLP — Certificate of Clinical Competence in Speech-Language Pathology
A speech-language pathologist certified by ASHA.

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Practice location Address checks out

593 NW York Dr
Bend, OR 97703-7264
Phone: (971) 346-0355
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Speech-Language Pathologist (primary) Taxonomy 235Z00000X · Licence 18242 (OR)
Speech-Language Pathologist Taxonomy 235Z00000X · Licence TSLP-4434 (ID)
Speech-Language Pathologist Taxonomy 235Z00000X (ID)

Record details

NPI number1114531480
Entity typeIndividual (Type 1)
GenderFemale
Credentials MS , CCC-SLP
Sole proprietorNo
NPI enumeratedSeptember 3, 2020
Last updated in NPPESSeptember 5, 2024
Certification dateSeptember 5, 2024

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