Individual
KATIE MANSOURA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
14645 SW FARMINGTON RD, BEAVERTON, OR 97007-2727
(503) 643-8626
Mailing address
4015 SW PASADENA ST, PORTLAND, OR 97219-9524
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
14020
OR
Other
Enumeration date
03/13/2014
Last updated
03/13/2014
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