Individual
SARA WALLACE NOWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S. CCC-SLP
Contact information
Practice address
707 SW GAINES ST, PORTLAND, OR 97239-2901
(503) 494-8095
Mailing address
707 SW GAINES ST, PORTLAND, OR 97239-2901
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
13508
OR
Other
Enumeration date
05/17/2012
Last updated
11/13/2012
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