Individual
ALLEGRA LIEDTKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS
Contact information
Practice address
10180 SE SUNNYSIDE RD, CLACKAMAS, OR 97015-8970
(503) 571-3838
Mailing address
21315 NW ROCK CREEK BLVD, PORTLAND, OR 97229-1043
(971) 235-9535
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
OR
Other
Enumeration date
07/20/2015
Last updated
07/20/2015
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