Individual
ELENA J KINGSTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1636 SW BROOKLANE DR, CORVALLIS, OR 97333-1633
(831) 239-9995
Mailing address
1636 SW BROOKLANE DR, CORVALLIS, OR 97333-1633
(831) 239-9995
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
015796
OR
Other
Enumeration date
06/29/2022
Last updated
06/29/2022
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