Individual
GARRETT ANDREW PORTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS CFY-SLP
Contact information
Practice address
1111 CRATER LAKE AVE, MEDFORD, OR 97504-6241
(541) 732-5000
Mailing address
918 S HOLLY ST, MEDFORD, OR 97501-3643
(435) 632-9916
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
016286
OR
Other
Enumeration date
08/07/2018
Last updated
08/07/2018
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