Individual
MS. KELLI MURDOCK EICKELBERG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, CCC-SLP
Contact information
Practice address
7701 SW CIRRUS DRIVE, SUITE 32-D, BEAVERTON, OR 97008-5966
(503) 520-5030
(503) 520-5090
Mailing address
7701 SW CIRRUS DRIVE, SUITE 32-D, BEAVERTON, OR 97008-5966
(503) 520-5030
(503) 520-5090
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
10960
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10960
OREGAON STATE LICENSE
OR
01
—
LL60802215
WA STATE LICENSE
WA
Enumeration date
04/02/2007
Last updated
09/03/2019
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