Individual
MS. KIM MICHELE ELLIOTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, CCC-SLP
Contact information
Practice address
1645 N CHURCH ST, PORTLAND, OR 97217-4514
(503) 708-5720
Mailing address
1645 N CHURCH ST, PORTLAND, OR 97217-4514
(503) 289-5584
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
13057
OR
Other
Enumeration date
02/16/2011
Last updated
02/16/2011
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