Doctor Name: | DR. JEFF CONN |
NPI Number: | 1124415716 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | CCC-SLP |
License Number: | 15034 |
Business Practice Address: | 75 Shore Dr Saint Helens, OR - 970511125 |
Business Phone Number: | 5033972713 |
Business Fax Number: | |
Mailing Address: | 7124 N Jersey St, PORTLAND |
State: | OR |
Postal Code: | 972033953 |
Phone Number: | 9712750755 |
Fax Number: | |
NPI Enumeration Date: | 04/21/2015 |
NPI Last Update Date: | 04/21/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 15034 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OR |
Taxonomy Type: | Speech, Language and Hearing Service Providers |
Taxonomy Classification: | Speech-Language Pathologist |
Taxonomy Specialization: | |
Taxonomy Definition: | A speech pathologist is a person qualified by a master |