Individual
DAWN M MALLARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SLPA
Contact information
Practice address
6723 SE 16TH AVE, PORTLAND, OR 97202-5706
(503) 421-8629
Mailing address
6723 SE 16TH AVE # 82832, PORTLAND, OR 97202-5706
(503) 421-8629
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
A0738
OR
Other
Enumeration date
06/21/2021
Last updated
06/21/2021
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