Provider Demographics
NPI:1619866571
Name:FREYSINGER, MICHAEL GLANE (MS)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:GLANE
Last Name:FREYSINGER
Suffix:
Gender:M
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5525 HIGH LEAD DR
Mailing Address - Street 2:
Mailing Address - City:MOUNT HOOD PARKDALE
Mailing Address - State:OR
Mailing Address - Zip Code:97041-7804
Mailing Address - Country:US
Mailing Address - Phone:971-678-9750
Mailing Address - Fax:
Practice Address - Street 1:4560 SE INTERNATIONAL WAY STE 100
Practice Address - Street 2:
Practice Address - City:MILWAUKIE
Practice Address - State:OR
Practice Address - Zip Code:97222-4628
Practice Address - Country:US
Practice Address - Phone:971-206-5223
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-02
Last Update Date:2025-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR18544235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist