Individual
MOLLY ANN PRIDEAUX
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
19185 SW 90TH AVE, TUALATIN, OR 97062-7558
(503) 885-7300
Mailing address
5288 BROADWAY ST, WEST LINN, OR 97068-3306
(541) 510-3482
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
12646
OR
Other
Enumeration date
08/25/2006
Last updated
12/22/2021
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