| Doctor Name: | SHELLY JO MENDOZA |
| NPI Number: | 1336455732 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | SLP |
| License Number: | 13386 |
| Business Practice Address: | 490 North Second Street Suite C Coos Bay, OR - 974202370 |
| Business Phone Number: | 5412675221 |
| Business Fax Number: | 5412675222 |
| Mailing Address: | 3270 Liberty Rd S, SALEM |
| State: | OR |
| Postal Code: | 97302 |
| Phone Number: | 5033710779 |
| Fax Number: | 5033710886 |
| NPI Enumeration Date: | 08/23/2010 |
| NPI Last Update Date: | 03/11/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | 13386 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| 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 |