Provider Demographics
NPI:1710763735
Name:MADELYN UELAND LLC
Entity Type:Organization
Organization Name:MADELYN UELAND LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MADELYN
Authorized Official - Middle Name:
Authorized Official - Last Name:UELAND
Authorized Official - Suffix:
Authorized Official - Credentials:MS CCC-SLP
Authorized Official - Phone:503-853-0959
Mailing Address - Street 1:5411 SW DOLPH DR
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97219-3243
Mailing Address - Country:US
Mailing Address - Phone:503-853-0959
Mailing Address - Fax:
Practice Address - Street 1:7420 SW HUNZIKER RD STE B
Practice Address - Street 2:
Practice Address - City:TIGARD
Practice Address - State:OR
Practice Address - Zip Code:97223-8242
Practice Address - Country:US
Practice Address - Phone:503-853-0959
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-05
Last Update Date:2023-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty