Individual
KERRY ANNE ROEDIGER
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
1722 NW RALEIGH ST, SUITE 318, PORTLAND, OR 97209-1753
(503) 224-2820
(503) 224-2607
Mailing address
1722 NW RALEIGH ST, SUITE 318, PORTLAND, OR 97209-1753
(503) 224-2820
(503) 224-2607
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
12293
OR
235Z00000X
Speech-Language Pathologist
LL00003688
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
09138419
ASHA CERTIFICATION - SLP
—
01
—
12293
OREGON LICENSE - SLP
OR
05
—
182755
—
OR
05
—
7131154
—
WA
01
—
LL00003688
WAHINGTON LICENSE - SLP
WA
Enumeration date
06/03/2006
Last updated
07/09/2007
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