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GREEN HILLS PEDIATRIC THERAPY INC. NPI 1093165623


NPI Information

NPI: 1093165623
Provider Name: GREEN HILLS PEDIATRIC THERAPY, INC.
Classification: Clinic/Center - 261QH0700X
Entity Type: Organization

Specialization: Hearing and Speech

Address:
5319 SW WESTGATE DR STE 120
PORTLAND, OR
ZIP 97221
Phone: (503) 297-4052
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GREEN HILLS PEDIATRIC THERAPY, INC. is a hearing and speech clinic center in Portland, OR. The provider is an entity, facility, or distinct part of a facility providing diagnostic, treatment, prescriptive, and therapy services related to congenital and acquired conditions and diseases that affect hearing capacity and speech ability. GREEN HILLS PEDIATRIC THERAPY, INC. NPI is 1093165623. The provider is registered as an organization entity type.

The provider's business location address is:

5319 SW WESTGATE DR STE 120
PORTLAND, OR
ZIP 97221-313
Phone: (503) 297-4052
Fax: (503) 297-4401

The provider's authorized official is Anna Jeddeloh Waters .
The authorized official title is Speech-language Pathologist and has the following contact phone number (503) 297-4052.

The enumeration date for this NPI number is 6/14/2016 and was last updated on 10/20/2016.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1261QH0700XClinic/CenterHearing and Speech13433OREGONNo
2261QH0700XClinic/CenterHearing and Speech13313OREGONYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1500693103MEDICAIDOREGON

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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