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Organization
ELLINGSEN SPEECH THERAPY, LLC
Active
Organization
ELLINGSEN SPEECH THERAPY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
QUINN ELLINGSEN MS, CCC-SLP (OWNER/ SPEECH LANGUAGE PATHOLOGIST)
(503) 564-0565
Entity
Organization
Contact information
Practice address
8050 SW WARM SPRINGS ST, SUITE 130, TUALATIN, OR 97062-7424
(503) 564-0565
Mailing address
8050 SW WARM SPRINGS ST, SUITE 130, TUALATIN, OR 97062-7424
(503) 564-0565
Taxonomy
Speciality
Code
Description
License number
State
261QH0700X
Hearing and Speech Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1386054625
PERSONAL PROVIDER NPI
—
01
—
1568718013
PERSONAL PROVIDER NPI
—
Enumeration date
07/10/2015
Last updated
07/10/2015
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