Roediger, Kerry Anne

Roediger, Kerry Anne is an individual health care provider with primary practice located at 1722 Nw Raleigh St Suite 318, Portland OR 97209-1753. 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. Roediger, Kerry Anne can be contacted via phone (503) 224-2820.

Contact Information

Primary practice address
1722 Nw Raleigh St Suite 318 Portland OR 97209-1753
Phone: (503) 224-2820
Fax: (503) 224-2607
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Speech, Language and Hearing Service Providers / Speech-Language Pathologist 235Z00000X LL00003688 Washington
Speech, Language and Hearing Service Providers / Speech-Language Pathologist 235Z00000X 12293 Oregon

Profile Details

NPI number 1528006368
LBN Legal business name Roediger, Kerry Anne
Credentials SLP
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 3rd, 2006
Last updated Jul 9th, 2007 - about 19 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 1528006368 NPPES
Other 09138419 ASHA CERTIFICATION - SLP
MEDICAID 182755 ASHA CERTIFICATION - SLP
Other 12293 ASHA CERTIFICATION - SLP
MEDICAID 7131154 ASHA CERTIFICATION - SLP
Other LL00003688 ASHA CERTIFICATION - SLP

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