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

Individual provider Speech-Language Pathologist · NPI 1790944684

Mr. Nisanth Panicker, MS, CCC-SLP is a Qualified Speech Language Pathologist in Puyallup, Washington. Qualified in 2000, 26 years ago. Practices with Fox Rehab SLP Fl LLC, a 23-clinician group and accepts Medicare assignment. Licensed in Washington.

Years since qualifying
26
Licensed in
WA
In the registry since
2008
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

920 12th Ave SE
Puyallup, WA 98372-4920
Phone: (253) 841-3422
Fax: (206) 445-4043
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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 LL00004115 (WA)

Record details

NPI number1790944684
Entity typeIndividual (Type 1)
GenderMale
Credentials MS , CCC-SLP
Sole proprietorNo
NPI enumeratedJune 5, 2008
Last updated in NPPESJuly 17, 2026
Certification dateJuly 17, 2026

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyQUALIFIED SPEECH LANGUAGE PATHOLOGIST
Medical schoolOTHER
Graduated 2000 (26 years in practice)
Group practice Fox Rehab Slp Fl Llc — 23 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Puyallup