Provider Demographics
NPI:1689190134
Name:CABALLERO, ISABELLE COOPER KLEE (MS CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:ISABELLE
Middle Name:COOPER KLEE
Last Name:CABALLERO
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:ISABELLE
Other - Middle Name:COOPER
Other - Last Name:KLEE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS CCC-SLP
Mailing Address - Street 1:17020 SW UPPER BOONES FERRY ROAD SUITE 201
Mailing Address - Street 2:
Mailing Address - City:TIGARD
Mailing Address - State:OR
Mailing Address - Zip Code:97224
Mailing Address - Country:US
Mailing Address - Phone:503-894-1539
Mailing Address - Fax:503-210-1453
Practice Address - Street 1:17020 SW UPPER BOONES FERRY ROAD SUITE 201
Practice Address - Street 2:
Practice Address - City:TIGARD
Practice Address - State:OR
Practice Address - Zip Code:97224
Practice Address - Country:US
Practice Address - Phone:503-894-1539
Practice Address - Fax:503-210-1453
Is Sole Proprietor?:No
Enumeration Date:2017-08-16
Last Update Date:2020-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR016043235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist