Provider Demographics
NPI:1336653518
Name:DONART, LAURA MICHELLE (SLP)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:MICHELLE
Last Name:DONART
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:LAURA
Other - Middle Name:MICHELLE
Other - Last Name:EUBANKS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:SLP
Mailing Address - Street 1:PO BOX 3158
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97208-3158
Mailing Address - Country:US
Mailing Address - Phone:503-215-6494
Mailing Address - Fax:
Practice Address - Street 1:310 VILLA RD STE 101
Practice Address - Street 2:
Practice Address - City:NEWBERG
Practice Address - State:OR
Practice Address - Zip Code:97132-1886
Practice Address - Country:US
Practice Address - Phone:503-537-3546
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-11-26
Last Update Date:2022-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR015612235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist