Provider Demographics
NPI:1497484281
Name:KATZKE, GRACE (CF - SLP)
Entity Type:Individual
Prefix:
First Name:GRACE
Middle Name:
Last Name:KATZKE
Suffix:
Gender:F
Credentials:CF - SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11570 SW CARDINAL TER
Mailing Address - Street 2:
Mailing Address - City:BEAVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97008-5956
Mailing Address - Country:US
Mailing Address - Phone:971-275-2525
Mailing Address - Fax:
Practice Address - Street 1:441 N WERTH BLVD
Practice Address - Street 2:
Practice Address - City:NEWBERG
Practice Address - State:OR
Practice Address - Zip Code:97132-7500
Practice Address - Country:US
Practice Address - Phone:503-538-9436
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-07
Last Update Date:2022-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist