Individual
JOANNA KISHPAUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2783 RIDGEWAY DR SE, TURNER, OR 97392-9370
(541) 913-4740
(503) 581-8906
Mailing address
2783 RIDGEWAY DR SE, TURNER, OR 97392-9370
(541) 913-4740
(503) 581-8906
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
10757
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01035967
AMERICAN SPEECH LANGUAGE HEARING ASSOCIATION
OR
01
—
10757
OREGON BOARD OF EXAMINERS FOR SPEECH LANGUAGE PATHOLOGY AND AUDIOLOGY
OR
Enumeration date
08/08/2016
Last updated
08/08/2016
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