| NPI | 1801012695 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAN JOHNSON Program Coordinator 541-342-1980 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: OR 10584) |
| Enumeration Date | 2007-04-18 |
| Last Update Date | 2020-08-22 |