Organization
CREATING PATHWAYS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMIE MARIE RUIZ (OFFICE MANAGER)
(503) 926-4299
Entity
Organization
Contact information
Practice address
3871 FAIRVIEW INDUSTRIAL DR SE STE 150, SALEM, OR 97302
(503) 926-4299
(503) 926-9322
Mailing address
3871 FAIRVIEW INDUSTRIAL DR SE STE 150, SALEM, OR 97302-1172
(503) 926-4299
(503) 926-9322
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
1069889
OR
235Z00000X
Speech-Language Pathologist
Primary
12564
OR
Other
Enumeration date
06/10/2013
Last updated
06/21/2019
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