Individual
KENNETH DANIEL O'DEA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CCC-SLP
Contact information
Practice address
366 N HOLLY ST, CANBY, OR 97013-3739
(503) 908-6120
Mailing address
11775 SE MARKET ST, PORTLAND, OR 97216-3914
(650) 740-9563
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
16852
OR
Other
Enumeration date
09/11/2023
Last updated
09/11/2023
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