MEDICARE: MRS. SHELLEY LANE LOWREY 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
2	235Z00000X	Speech-Language Pathologist	18233	TX

General Provider Information

NPI Number	:	1427215730
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. SHELLEY LANE LOWREY CCC-SLP

Provider Business Mailing Address
First Line	:	4988 WIND STONE WAY NE
Second Line	:
City	:	SALEM
State	:	OR
Zip	:	97301-2979
Country	:	US
Telephone Number	:	254-717-2107
Fax Number	:	254-717-2107

Provider Business Practice Location Address
First Line	:	4988 WIND STONE WAY NE
Second Line	:
City	:	SALEM
State	:	OR
Zip	:	97301-2979
Country	:	US
Telephone Number	:	254-717-2107
Fax Number	:	254-717-2107

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

Provider Enumeration Date	:	05/22/2008
Last Update Date	:	09/01/2023

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Directions to “ MRS. SHELLEY LANE LOWREY CCC-SLP” Practice Location

Language	Start Address	Practice Location

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