Individual
MS. DANIELLE ASHLEY BAKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.A., CCC-SLP
Contact information
Practice address
1717 SE 43RD AVE, PORTLAND, OR 97215-3115
(503) 568-1781
(503) 710-9534
Mailing address
1717 SE 43RD AVE, PORTLAND, OR 97215-3115
(503) 568-1781
(503) 710-9534
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
109321
TX
235Z00000X
Speech-Language Pathologist
Primary
15419
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
15419
OREGON STATE BOARD OF LICENSURE FOR SPEECH PATHOLOGY AND AUDIOLOGY
OR
05
—
500687686
—
OR
Enumeration date
08/22/2013
Last updated
08/26/2020
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