Provider Demographics
NPI:1053460600
Name:HARRINGTON, JILL ANNETTE (SPEECH LANGUAGE PATH)
Entity Type:Individual
Prefix:
First Name:JILL
Middle Name:ANNETTE
Last Name:HARRINGTON
Suffix:
Gender:F
Credentials:SPEECH LANGUAGE PATH
Other - Prefix:
Other - First Name:JILL
Other - Middle Name:ANNETTE
Other - Last Name:BROWN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 716
Mailing Address - Street 2:
Mailing Address - City:TROUTDALE
Mailing Address - State:OR
Mailing Address - Zip Code:97060-0716
Mailing Address - Country:US
Mailing Address - Phone:503-522-7721
Mailing Address - Fax:
Practice Address - Street 1:31140 SE OXBOW DR
Practice Address - Street 2:
Practice Address - City:TROUTDALE
Practice Address - State:OR
Practice Address - Zip Code:97060-8417
Practice Address - Country:US
Practice Address - Phone:503-522-7721
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-10
Last Update Date:2013-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR11857235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist