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Organization

CLACKAMAS SPEECH LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
HEIDII ILONA ROBERTS CCCSLP (SLP/OWNER)
(503) 654-1014
Entity
Organization

Contact information

Practice address
2305 SE WASHINGTON ST STE 102, MILWAUKIE, OR 97222-7647
(503) 654-1014
Mailing address
2305 SE WASHINGTON ST STE 102, MILWAUKIE, OR 97222-7647
(503) 654-1014

Taxonomy

Speciality
Code
Description
License number
State
261QH0700X
Hearing and Speech Clinic/Center
Primary
11741
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
500656249
OR
Enumeration date
02/23/2015
Last updated
02/23/2015
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