Individual
DARYL E. ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
707 SW GAINES ST, PORTLAND, OR 97239-2901
(800) 452-3563
Mailing address
2424 SW SEYMOUR DR, PORTLAND, OR 97239-2152
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
10307
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
295688
—
OR
Enumeration date
08/03/2006
Last updated
07/08/2007
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