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General NPI Number Information
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NPI Number | 1609435023
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Entity Type | Individual
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Provider Name | COURTNEY DAWN WELCH MS SLP
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Gender | Female
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Dates
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Enumeration Date | 06/10/2019
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Last Update Date | 06/10/2019
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Provider Practice Location Address
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Address Line | 326 SW 7TH ST
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City | REDMOND
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State | OR
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Zip | 97756-2205
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Country | US
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Telephone | 541-238-5551
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Fax |
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Provider Business Mailing Address
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Address Line | 20720 EMPIRE AVE APT 120
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City | BEND
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State | OR
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Zip | 97701-4790
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Country | US
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Telephone | 541-388-3437
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Fax |
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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 | 016519
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License Number State | OR
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