Individual
KATHERINE COLL MABOU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1204 NE 201ST AVE, FAIRVIEW, OR 97024-2499
(503) 661-7200
Mailing address
1204 NE 201ST AVE, FAIRVIEW, OR 97024-2499
(503) 661-7200
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
18134
OR
235Z00000X
Speech-Language Pathologist
6524
LA
Other
Enumeration date
12/20/2023
Last updated
09/20/2024
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