Individual
DEBORAH SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS CCC-SLP
Contact information
Practice address
10140 SW PAULINA DR, TUALATIN, OR 97062-8549
(503) 887-1130
Mailing address
818 SW 3RD AVE # 68, PORTLAND, OR 97204-2405
(503) 887-1130
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
10500
OR
Other
Enumeration date
02/27/2013
Last updated
02/27/2013
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