Healthcare Provider Details

I. General information

NPI: 1386392785
Provider Name (Legal Business Name): EMPOWER SPEECH THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/15/2022
Last Update Date: 08/09/2026
Certification Date: 08/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18861 SW MARTINAZZI AVE # 203
TUALATIN OR
97062-7457
US

IV. Provider business mailing address

18861 SW MARTINAZZI AVE # 203
TUALATIN OR
97062-7457
US

V. Phone/Fax

Practice location:
  • Phone: 503-878-5075
  • Fax:
Mailing address:
  • Phone: 503-278-2484
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MCKENZIE RUSHCAMP
Title or Position: SPEECH-LANGUAGE PATHOLOGIST
Credential:
Phone: 503-278-2484