Individual
ELSA BRO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5524 SE OAK ST, PORTLAND, OR 97215-1272
(541) 490-8405
Mailing address
5524 SE OAK ST, PORTLAND, OR 97215-1272
(541) 490-8405
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
LL60598165
WA
Other
Enumeration date
11/10/2015
Last updated
11/10/2015
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