Provider Demographics
NPI:1528604824
Name:WELLNESS GROUP FOR VOICE SPEECH AND SWALLOWING
Entity Type:Organization
Organization Name:WELLNESS GROUP FOR VOICE SPEECH AND SWALLOWING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR, SPEECH PATHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:AARON
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:ZIEGLER
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, CCC-SLP
Authorized Official - Phone:503-946-6907
Mailing Address - Street 1:3549 NE 65TH AVE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97213-4417
Mailing Address - Country:US
Mailing Address - Phone:503-946-6907
Mailing Address - Fax:971-217-9841
Practice Address - Street 1:3549 NE 65TH AVE
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97213-4417
Practice Address - Country:US
Practice Address - Phone:503-946-6907
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-21
Last Update Date:2023-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty