Provider Demographics
NPI:1639597735
Name:SCHINDLBECK, KAIA WAKAMIYA (MS CCC-SLP)
Entity Type:Individual
Prefix:
First Name:KAIA
Middle Name:WAKAMIYA
Last Name:SCHINDLBECK
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:KAIA
Other - Middle Name:MARIE
Other - Last Name:WAKAMIYA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS CCC-SLP
Mailing Address - Street 1:113 N ELM ST
Mailing Address - Street 2:
Mailing Address - City:CANBY
Mailing Address - State:OR
Mailing Address - Zip Code:97013-3519
Mailing Address - Country:US
Mailing Address - Phone:503-263-8903
Mailing Address - Fax:503-266-8632
Practice Address - Street 1:5289 NE ELAM YOUNG PKWY STE 140
Practice Address - Street 2:
Practice Address - City:HILLSBORO
Practice Address - State:OR
Practice Address - Zip Code:97124-7551
Practice Address - Country:US
Practice Address - Phone:503-747-5359
Practice Address - Fax:503-266-8632
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-04
Last Update Date:2023-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA21740235Z00000X
OR016265235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist