Healthcare Provider Details

I. General information

NPI: 1275125411
Provider Name (Legal Business Name): TRINITY THOMAS M.S. CF-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/09/2021
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2001 SW NYE AVE
PENDLETON OR
97801-4416
US

IV. Provider business mailing address

2001 SW NYE AVE
PENDLETON OR
97801-4416
US

V. Phone/Fax

Practice location:
  • Phone: 541-966-3100
  • Fax:
Mailing address:
  • Phone: 541-966-3100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number18832
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: