Individual
DOUGLAS SCOTT PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
SLP
Contact information
Practice address
1815 SW MARLOW, STE 110, PORTLAND, OR 97225-5185
(503) 292-0765
(503) 292-5208
Mailing address
1815 SW MARLOW, STE 110, PORTLAND, OR 97225-5185
(503) 292-0765
(503) 292-5208
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
10536
OR
Other
Enumeration date
09/11/2006
Last updated
07/08/2007
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