HAYDEN GANDOLFI
NPI 1720722218
Speech-Language Pathologist in Longview, WA

Q: What is Hayden Gandolfi's NPI number?

The NPI number for Hayden Gandolfi is 1720722218. It was assigned to this individual provider in the NPPES registry on April 21, 2022.

Q: What is Hayden Gandolfi's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Hayden Gandolfi was last updated on April 21, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years 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.

Active since April 21, 2022

2715 LILAC ST, LONGVIEW, WA 98632(360) 575-7000 Get Directions Write a Review

NPPES record last updated: April 21, 2022. Verified against the NPPES registry weekly; last sync: August 16, 2026.

On this page

About Hayden Gandolfi NPPES

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

HAYDEN GANDOLFI (NPI 1720722218) is an individual speech-language pathologist provider in Longview, Washington, licensed in Michigan (7101007378) and active in the NPI registry since April 2022. He is a graduate of Other (2019).

NPPES Registry Identity

NPI1720722218

Entity TypeIndividualMale

Primary Taxonomy235Z00000X

Provider Legal NameHAYDEN GANDOLFI

Location Address2715 LILAC STLongview, WA 98632-3526

Mailing Address27077 Dartmouth StMadison Heights, MI 48071-3235

Phone(360) 575-7000

Sole ProprietorYes

Medical School CMSOtherGraduated 2019

Enumeration DateApril 21, 2022

NPPES CertifiedApril 21, 2022

✔ NPI 1720722218 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 MI · 7101007378

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.

2715 LILAC ST, Longview, WA 98632

Open in Google Maps ↗

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Hayden Gandolfi is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID4880164151

PECOS Enrollment IDI20260528000229

Other Providers at the Same Location NPPES 19

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

JONATHAN KYRTIS MONTANO OTR

Occupational Therapist