Individual
KELLY WULFF
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CCC-SLP
Contact information
Practice address
9205 SW BARNES RD, PORTLAND, OR 97225-6603
(775) 338-7157
Mailing address
16200 SW BASELINE RD, BEAVERTON, OR 97006-4916
(775) 338-7157
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
015834
OR
Other
Enumeration date
08/02/2018
Last updated
08/02/2018
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