| NPI | 1245813088 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRAVIS MARTIN DOCKTER Speech Language Pathologist 971-282-3575 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, |
| Enumeration Date | 2021-04-29 |
| Last Update Date | 2021-04-29 |