Individual
KRYSTIN BRACKETT OVERSTREET
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CCC-SLP
Contact information
Practice address
25117 SW PARKWAY AVE STE D, WILSONVILLE, OR 97070-9697
(503) 816-4758
Mailing address
3915 SE IVON ST, PORTLAND, OR 97202-1650
(503) 817-4758
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
15125
OR
235Z00000X
Speech-Language Pathologist
LL 60537627
WA
Other
Enumeration date
05/04/2015
Last updated
05/04/2015
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