Healthcare Provider Details

I. General information

NPI: 1730025305
Provider Name (Legal Business Name): BRITTANY ILY OSBORNE MS CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/27/2026
Last Update Date: 04/27/2026
Certification Date: 04/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

546 CHADWICK LN
MYRTLE CREEK OR
97457-8702
US

IV. Provider business mailing address

PO BOX 452
RIDDLE OR
97469-0452
US

V. Phone/Fax

Practice location:
  • Phone: 707-816-0572
  • Fax:
Mailing address:
  • Phone: 707-816-0572
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number17978
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: