Individual
SHELLY JO MENDOZA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
490 NORTH SECOND STREET, SUITE C, COOS BAY, OR 97420-2370
(541) 267-5221
(541) 267-5222
Mailing address
3270 LIBERTY RD S, SALEM, OR 97302
(503) 371-0779
(503) 371-0886
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
013386
OR
235Z00000X
Speech-Language Pathologist
13386
OR
Other
Enumeration date
08/23/2010
Last updated
03/11/2015
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