Provider Demographics
NPI:1275844599
Name:COX, ANNA (MS SLP-CCC)
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:
Last Name:COX
Suffix:
Gender:F
Credentials:MS SLP-CCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5209 E BURNSIDE ST
Mailing Address - Street 2:APT. 4
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97215-1180
Mailing Address - Country:US
Mailing Address - Phone:503-704-1357
Mailing Address - Fax:
Practice Address - Street 1:5209 E BURNSIDE ST
Practice Address - Street 2:APT. 4
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97215-1180
Practice Address - Country:US
Practice Address - Phone:503-704-1357
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-01
Last Update Date:2010-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR13177235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist