Provider Demographics
NPI:1821349523
Name:HOLDEN, LAURA M (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:M
Last Name:HOLDEN
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10300 SW GREENBURG RD
Mailing Address - Street 2:1LINCOLN CENTER SUITE 410
Mailing Address - City:TIGARD
Mailing Address - State:OR
Mailing Address - Zip Code:97223-5410
Mailing Address - Country:US
Mailing Address - Phone:503-517-8555
Mailing Address - Fax:
Practice Address - Street 1:4900 SW GRIFFITH DRIVE
Practice Address - Street 2:SUITE 157
Practice Address - City:BEAVERTON
Practice Address - State:OR
Practice Address - Zip Code:97005
Practice Address - Country:US
Practice Address - Phone:503-517-8555
Practice Address - Fax:503-517-8556
Is Sole Proprietor?:No
Enumeration Date:2012-09-21
Last Update Date:2021-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR14034235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist