Individual
MALLARY ELLYN OWEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS CCC-SLP
Contact information
Practice address
17020 SW UPPER BOONES FERRY RD STE 201, PORTLAND, OR 97224-7078
(503) 894-1539
Mailing address
6146 SW 46TH AVE, PORTLAND, OR 97221-2818
(602) 616-8248
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
17365
OR
Other
Enumeration date
08/25/2022
Last updated
08/25/2022
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