MEDICARE: GRACE PRIMROSE CHRISTENSEN MS, CCC-SLP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	SI60979070	WA
2	235Z00000X	Speech-Language Pathologist	016663	OR

General Provider Information

NPI Number	:	1205483658
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GRACE PRIMROSE CHRISTENSEN MS, CCC-SLP

Provider Business Mailing Address
First Line	:	13635 NW CORNELL RD STE 160
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97229-5885
Country	:	US
Telephone Number	:	360-989-7347
Fax Number	:

Provider Business Practice Location Address
First Line	:	13635 NW CORNELL RD STE 160
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97229-5885
Country	:	US
Telephone Number	:	360-989-7347
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/21/2019
Last Update Date	:	03/04/2025

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Directions to “ GRACE PRIMROSE CHRISTENSEN MS, CCC-SLP” Practice Location

Language	Start Address	Practice Location

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