Individual
SIRISHA R SUKRUTHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2300 WARREN ST, EUGENE, OR 97405-1116
(541) 686-2828
Mailing address
2300 WARREN ST, EUGENE, OR 97405-1116
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
17145
OR
Other
Enumeration date
11/01/2021
Last updated
11/01/2021
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