Individual
ELIZABETH PETERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, CCC-SLP
Contact information
Practice address
4016 SE 14TH AVE, PORTLAND, OR 97202-3920
(503) 309-8239
Mailing address
4016 SE 14TH AVE, PORTLAND, OR 97202-3920
(503) 309-8239
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
13167
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12130464
AMERICAN SPEECH, LANGUAGE & HEARING ASSOCIATION (ASHA)
—
01
—
13167
OREGON BOARD OF EXAMINERS FOR SPEECH-LANGUAGE PATHOLOGY AND AUDIOLOGY
OR
Enumeration date
05/12/2011
Last updated
08/26/2012
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