Individual
JOSEPH MYCHAYLO LAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CCC-SLP
Contact information
Practice address
385 TIMBER RIDGE ST NE, ALBANY, OR 97322-7425
(541) 926-2118
Mailing address
650 1ST AVE SE # 202, ALBANY, OR 97321-2744
(541) 981-9983
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
17554
OR
Other
Enumeration date
08/20/2025
Last updated
08/25/2025
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