Healthcare Provider Details

I. General information

NPI: 1437082997
Provider Name (Legal Business Name): ABIGAIL RILEY MIDDLETON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/04/2026
Last Update Date: 06/04/2026
Certification Date: 06/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8625 SW CASCADE AVE STE 320
BEAVERTON OR
97008-7126
US

IV. Provider business mailing address

4762 SE STARK ST
PORTLAND OR
97215-1744
US

V. Phone/Fax

Practice location:
  • Phone: 877-755-8940
  • Fax:
Mailing address:
  • Phone: 505-307-1408
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number18795
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: