Individual
MS. UTE KONGSBAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
10180 SE SUNNYSIDE RD, CLACKAMAS, OR 97015-8970
(503) 571-3822
Mailing address
8402 SE 9TH AVE, PORTLAND, OR 97202-6913
(503) 257-2933
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
11092
OR
235Z00000X
Speech-Language Pathologist
LL00003933
WA
Other
Enumeration date
08/30/2006
Last updated
07/08/2007
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