Provider Demographics
NPI:1437570330
Name:FREEMAN, ZOE KRISTIN (MS, SLP-CCC)
Entity Type:Individual
Prefix:
First Name:ZOE
Middle Name:KRISTIN
Last Name:FREEMAN
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 1:6127 SE 87TH AVE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97266-5325
Mailing Address - Country:US
Mailing Address - Phone:503-307-4538
Mailing Address - Fax:
Practice Address - Street 1:6127 SE 87TH AVE
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97266-5325
Practice Address - Country:US
Practice Address - Phone:503-307-4538
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-12-18
Last Update Date:2013-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR12226235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR12226OtherSTATE OF OREGON SPEECH LANGUAGE PATHOLOGY LICENCE NUMBER
12052494OtherAMERICAN SPEECH-LANGUAGE-HEARING ASSOCIATION