Mangan, Kristin Haines

Mangan, Kristin Haines is an individual health care provider with primary practice located at 707 Sw Gaines St , Portland OR 97239-2901. She recently has only one registered license in Speech, Language and Hearing Service Providers / Speech-Language Pathologist, which is considered as her primary health care specialty. Mangan, Kristin Haines can be contacted via phone (800) 452-3563.

Contact Information

Primary practice address
707 Sw Gaines St Portland OR 97239-2901
Phone: (800) 452-3563
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Speech, Language and Hearing Service Providers / Speech-Language Pathologist 235Z00000X 12642 Oregon

Profile Details

NPI number 1215945753
LBN Legal business name Mangan, Kristin Haines
Credentials CCC-SLP
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 3rd, 2006
Last updated Jul 8th, 2009 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1215945753 NPPES
Oregon MEDICAID 270054

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