Individual
AMANDA CORR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT, SLP
Contact information
Practice address
6165 NE ALTON ST, PORTLAND, OR 97213-3219
(503) 680-0900
Mailing address
6832 NE CLAREMONT AVE, PORTLAND, OR 97211-4042
(503) 680-0900
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
14579
OR
235Z00000X
Speech-Language Pathologist
Primary
18311
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
18311
OREGON BOARD OF SPEECH LANGUAGE PATHOLOGY
OR
Enumeration date
01/10/2011
Last updated
09/05/2024
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