Individual
MRS. PHAEDRA ANN URBAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
707 SW GAINES ST, PORTLAND, OR 97239-2901
(503) 494-8095
Mailing address
2241 LLOYD CTR, PORTLAND, OR 97232-1315
(503) 494-8417
(503) 494-5339
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
012829
OR
Other
Enumeration date
07/25/2007
Last updated
07/25/2007
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