Healthcare Provider Details

I. General information

NPI: 1295647758
Provider Name (Legal Business Name): JENNIFER ANDREWS MS, CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/21/2026
Last Update Date: 09/21/2026
Certification Date: 09/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2500 NE NEFF RD
BEND OR
97701-6015
US

IV. Provider business mailing address

6500 W 4905
PRYOR OK
74361-9038
US

V. Phone/Fax

Practice location:
  • Phone: 541-382-4321
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSP6243
License Number StateOK
# 2
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSP02054
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: