Organization
PATHWAY SPEECH THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELLECIA GRACE DECOUTEAU (OWNER)
(503) 654-4959
Entity
Organization
Contact information
Practice address
2035 SE WASHINGTON ST, MILWAUKIE, OR 97222-7612
(503) 654-4959
(503) 437-9454
Mailing address
2035 SE WASHINGTON ST, MILWAUKIE, OR 97222-7612
(503) 654-4959
(503) 437-9454
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
15632
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500744169
—
OR
01
—
R202809
PTAN
OR
Enumeration date
04/16/2018
Last updated
02/23/2022
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