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General NPI Number Information
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NPI Number | 1376488668
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Entity Type | Individual
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Provider Name | EVANGELINA VAZQUEZ-ORTEGA CCC-SLP
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Gender | Female
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Dates
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Enumeration Date | 04/22/2026
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Last Update Date | 04/22/2026
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Provider Practice Location Address
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Address Line | 755 MISSION ST SE
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City | SALEM
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State | OR
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Zip | 97302-6211
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Country | US
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Telephone | 503-269-7810
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Fax | 503-269-7810
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Provider Business Mailing Address
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Address Line | 1856 MADALYN CT NE
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City | KEIZER
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State | OR
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Zip | 97303-2077
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Country | US
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Telephone | 503-269-7810
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Fax | 503-269-7810
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 17506
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License Number State | OR
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