Individual
COURTNEY LACKEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S., CCC-SLP
Contact information
Practice address
3869 SW HALL BLVD, BEAVERTON, OR 97005-2049
(503) 946-5375
Mailing address
3869 SW HALL BLVD, BEAVERTON, OR 97005-2049
(503) 946-5375
(503) 626-0663
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
013431
OR
Other
Enumeration date
08/14/2014
Last updated
06/20/2025
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