Individual
MICHAEL JOHN CUSACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
29781 SW TOWN CENTER LOOP W STE 200, WILSONVILLE, OR 97070-8902
(503) 946-5375
Mailing address
9255 NE ROCKSPRING ST APT B222, HILLSBORO, OR 97006-2220
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
18602
OR
Other
Enumeration date
08/02/2025
Last updated
08/02/2025
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