Healthcare Provider Details

I. General information

NPI: 1730004649
Provider Name (Legal Business Name): ALLISON HEADLEY CF-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/11/2026
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

815 NW 9TH ST # 180
CORVALLIS OR
97330-6173
US

IV. Provider business mailing address

830 SW GROVE ST APT 9
CORVALLIS OR
97333-4059
US

V. Phone/Fax

Practice location:
  • Phone: 541-768-5157
  • Fax:
Mailing address:
  • Phone: 518-421-8054
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number18794
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: