MEDICARE: ANIA BROWN MS, CCC-SLP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	17013	OR
2	235Z00000X	Speech-Language Pathologist	LL61259854	WA

General Provider Information

NPI Number	:	1366118457
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANIA BROWN MS, CCC-SLP

Provider Business Mailing Address
First Line	:	13635 NW CORNELL RD STE 160
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97229-5885
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	13635 NW CORNELL RD STE 160
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97229-5885
Country	:	US
Telephone Number	:	360-989-7347
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/18/2021
Last Update Date	:	03/05/2025

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Directions to “ ANIA BROWN MS, CCC-SLP” Practice Location

Language	Start Address	Practice Location

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