Provider Demographics
NPI:1093397341
Name:KEY-DELYRIA, SARAH (CCC-SLP)
Entity Type:Individual
Prefix:DR
First Name:SARAH
Middle Name:
Last Name:KEY-DELYRIA
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3107 N KILPATRICK ST
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97217-6133
Mailing Address - Country:US
Mailing Address - Phone:503-374-6650
Mailing Address - Fax:
Practice Address - Street 1:3107 N KILPATRICK ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97217-6133
Practice Address - Country:US
Practice Address - Phone:503-374-6650
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-26
Last Update Date:2021-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR15015235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist