Individual
ANNA WATERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ED.D.
Contact information
Practice address
5319 SW WESTGATE DR, STE 120, PORTLAND, OR 97221-2313
(503) 297-4052
(503) 297-4401
Mailing address
5319 SW WESTGATE DR, STE 120, PORTLAND, OR 97221-2313
(503) 297-4052
(503) 297-4011
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
13313
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500693103
—
OR
Enumeration date
07/08/2015
Last updated
08/23/2016
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