| Doctor Name: | DR. RICHARD R LEMONCELLO |
| NPI Number: | 1538540554 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PHD, CCC/SLP |
| License Number: | 12474 |
| Business Practice Address: | 2043 College Way Pacific University / School Of Csd Forest Grove, OR - 97116 |
| Business Phone Number: | 5033521452 |
| Business Fax Number: | |
| Mailing Address: | 9424 Sw Wood Pkwy, PORTLAND |
| State: | OR |
| Postal Code: | 972195169 |
| Phone Number: | 5033604360 |
| Fax Number: | |
| NPI Enumeration Date: | 06/16/2015 |
| NPI Last Update Date: | 06/16/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | 12474 |
| 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 |