Individual
BARBARA ANN PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS CCCSLP
Contact information
Practice address
4560 SE INTERNATIONAL WAY, SUITE 100, MILWAUKIE, OR 97222
(971) 206-5129
(971) 206-5209
Mailing address
4560 SE INTERNATIONAL WAY, SUITE 100, MILWAUKIE, OR 97222
(971) 206-5129
(971) 206-5209
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
752
MT
235Z00000X
Speech-Language Pathologist
LL00004099
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
661440
BLUE CROSS BLUE SHIELD MT
—
Enumeration date
05/09/2007
Last updated
09/11/2025
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