SHIVAPRAKASH SHIVANNA

MILWAUKIE, OR
NPI1376411439
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy235Z00000X Speech-Language Pathologist,
(Licence: CA  17676)
Enumeration Date2025-10-29
Last Update Date2025-10-29
Business Address
Mr. SHIVAPRAKASH SHIVANNA
4560 SE INTERNATIONAL WAY STE 100
MILWAUKIE, OR 97222-4628
Phone number: 626-283-0101
Mailing Address
Mr. SHIVAPRAKASH SHIVANNA
4560 SE INTERNATIONAL WAY STE 100
MILWAUKIE, OR 97222-4628
Phone number: 626-283-0101
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