Individual
SAIGE MADISON FULTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6216 N MEARS ST, PORTLAND, OR 97203-1826
(503) 907-4747
Mailing address
6216 N MEARS ST, PORTLAND, OR 97203-1826
(503) 907-4747
Taxonomy
Speciality
Code
Description
License number
State
2355S0801X
Speech-Language Assistant
Primary
SLPA14823
AZ
Other
Enumeration date
09/25/2023
Last updated
09/25/2023
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