Individual
TERESA ROBERTS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3228 SE 59TH AVE, PORTLAND, OR 97206-2038
(503) 233-8221
Mailing address
3228 SE 59TH AVE, PORTLAND, OR 97206-2038
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
012075
OR
Other
Enumeration date
06/26/2015
Last updated
06/26/2015
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