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KATHERINE WIDESTROM
NPI 1699776252
Speech-Language Pathologist in Champlin, MN

Active since August 04, 2005
6025 109TH AVE N, CHAMPLIN, MN 55316(763) 506-7754 Get Directions Write a Review

NPPES record last updated: May 7, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Katherine Widestrom NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KATHERINE WIDESTROM (NPI 1699776252) is an individual speech-language pathologist provider in Champlin, Minnesota, licensed in Minnesota (7196) and active in the NPI registry since August 2005.

NPPES Registry Identity

NPI1699776252
Entity TypeIndividualFemale
Primary Taxonomy235Z00000X
Provider Legal NameKATHERINE WIDESTROM
Location Address6025 109TH AVE NChamplin, MN 55316-3475
Mailing Address6025 109th Ave NChamplin, MN 55316-3475 · (763) 506-7754
Phone(763) 506-7754
Sole ProprietorNo
Enumeration DateAugust 4, 2005
Last NPPES UpdateMay 7, 2026
NPPES CertifiedMay 7, 2026
✔ NPI 1699776252 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpeech-Language PathologistSpeech, Language and Hearing Service Providers
Taxonomy Code235Z00000X
License✔ Licensed in MN · 7196
Definition
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.
6025 109TH AVE N, Champlin, MN 55316
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Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MRS. JESSICA JEWEL HAWLEY ATC
Specialist/Technologist, Other
6025 109TH AVE N
CHAMPLIN, MN 55316
Hennepin County (952) 220-1879
ALEC EDWARD WEIS MS, LAT, ATC, CSCS
Specialist/Technologist (Athletic Trainer)
6025 109TH AVE N
CHAMPLIN, MN 55316
Hennepin County (763) 478-1360

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Katherine Widestrom's NPI number?

The NPI number for Katherine Widestrom is 1699776252. It was assigned to this individual provider in the NPPES registry on August 4, 2005.

Where is Katherine Widestrom located?

Katherine Widestrom practices at 6025 109th Ave N, Champlin, MN 55316. The listed phone number is (763) 506-7754.

What is Katherine Widestrom's specialty?

The primary specialty registered for this NPI is Speech-Language Pathologist with taxonomy code 235Z00000X.

When was this NPI record last updated?

The NPPES record for Katherine Widestrom was last updated on May 7, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.