Individual
IMOGENE PREISCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6557 E BURNSIDE ST, PORTLAND, OR 97215-1355
(415) 816-4636
Mailing address
6557 E BURNSIDE ST, PORTLAND, OR 97215-1355
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Enumeration date
11/03/2015
Last updated
11/03/2015
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