Individual
CARA R LACEY-MOREY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
550 NE SCOTT AVE, GRESHAM, OR 97030-6147
(503) 512-0825
Mailing address
550 NE SCOTT AVE, GRESHAM, OR 97030-6147
(503) 512-0825
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
12108
OR
235Z00000X
Speech-Language Pathologist
20932
CA
235Z00000X
Speech-Language Pathologist
2436
ID
235Z00000X
Speech-Language Pathologist
SLP7921
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1639141898
—
AZ
05
—
1639141898
—
CA
05
—
1639141898
—
ID
05
—
182812
—
OR
Enumeration date
02/02/2006
Last updated
04/20/2015
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