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Individual

JODY LYNN KOREPTA

Active
Sole proprietor

Provider details

NPI number
Gender
F
Credential
SPEECH THERAPIST

Contact information

Practice address
1315 NW 4TH ST, SUITE B, REDMOND, OR 97756-1328
(541) 923-7494
(541) 504-9153
Mailing address
11481 SW HALL BLVD, SUITE 201, PORTLAND, OR 97223-8403
(800) 219-8835
(503) 443-1402

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
11215
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
227946
OR
Enumeration date
12/02/2005
Last updated
07/08/2007
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