Individual
DR. RICHARD R LEMONCELLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD, CCC/SLP
Contact information
Practice address
2043 COLLEGE WAY, PACIFIC UNIVERSITY / SCHOOL OF CSD, FOREST GROVE, OR 97116
(503) 352-1452
Mailing address
9424 SW WOOD PKWY, PORTLAND, OR 97219-5169
(503) 360-4360
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
12474
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12027743
ASHA NATIONAL CERTIFICATION
—
01
—
12474
OR LICENSE TO PRACTICE SPEECH-LANGUAGE PATHOLOGY
OR
Enumeration date
06/16/2015
Last updated
06/16/2015
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