Individual
KIM M COTTRELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CCC-SLP
Contact information
Practice address
3939 NE HANCOCK ST, SUITE 212, PORTLAND, OR 97212-5321
(503) 890-6865
Mailing address
3939 NE HANCOCK ST, SUITE 212, PORTLAND, OR 97212-5321
(503) 890-6865
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
10798
OR
Other
Enumeration date
12/02/2006
Last updated
07/08/2007
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