MEDICARE: MRS. BRIGITTE IVONNE MARENIN 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	17869	OR

General Provider Information

NPI Number	:	1902585458
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. BRIGITTE IVONNE MARENIN CCC-SLP

Provider Business Mailing Address
First Line	:	665 WINTER ST SE BLDG B
Second Line	:
City	:	SALEM
State	:	OR
Zip	:	97301-3934
Country	:	US
Telephone Number	:	626-590-7013
Fax Number	:

Provider Business Practice Location Address
First Line	:	665 WINTER ST SE BLDG B
Second Line	:
City	:	SALEM
State	:	OR
Zip	:	97301-3934
Country	:	US
Telephone Number	:	503-814-9211
Fax Number	:

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

Provider Enumeration Date	:	07/12/2023
Last Update Date	:	04/15/2026

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