Provider Demographics
NPI:1275889487
Name:FLOERSCH, COURTNEY L (SLP)
Entity Type:Individual
Prefix:
First Name:COURTNEY
Middle Name:L
Last Name:FLOERSCH
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:COURTNEY
Other - Middle Name:L
Other - Last Name:ROOD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:SLP
Mailing Address - Street 1:16262 SW SUMAC ST
Mailing Address - Street 2:
Mailing Address - City:BEAVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97007-4887
Mailing Address - Country:US
Mailing Address - Phone:503-970-7666
Mailing Address - Fax:
Practice Address - Street 1:14780 SW OSPREY DR STE 285
Practice Address - Street 2:
Practice Address - City:BEAVERTON
Practice Address - State:OR
Practice Address - Zip Code:97007-8073
Practice Address - Country:US
Practice Address - Phone:503-454-6266
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-25
Last Update Date:2021-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA7637235Z00000X
OR015444235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR500719170Medicaid