| Organization Name: | CREEKSIDE SPEECH THERAPY |
| NPI Number: | 1619392677 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | TRACY ADAMS (OWNER) |
| Mailing Address: | 27196 Sw Baker Rd Sherwood |
| State: | OR US |
| Postal Code: | 971408408 |
| Phone Number: | 7194946374 |
| Fax Number: | 8662198556 |
| NPI Enumeration Date: | 02/27/2014 |
| NPI Last Update Date: | 02/27/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | 14082 |
| 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 |