| NPI | 1255600748 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMIE LYNN DAVIS Speech Language Pathologist 503-901-5652 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist (Licence: OR 12656) |
| Enumeration Date | 2011-12-29 |
| Last Update Date | 2011-12-29 |