Healthcare Provider Details

I. General information

NPI: 1659292233
Provider Name (Legal Business Name): MICHELE LEE MORTON MS, CCC/SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/21/2026
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

123 SW COLUMBIA ST STE 100
BEND OR
97702-3609
US

IV. Provider business mailing address

PO BOX 1600
REDMOND OR
97756-0511
US

V. Phone/Fax

Practice location:
  • Phone: 541-204-1757
  • Fax: 541-632-8299
Mailing address:
  • Phone: 541-204-1757
  • Fax: 541-632-8299

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number18856
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: