Provider Demographics
NPI:1972213056
Name:NIETO, ASHLEY BROOKE (CF-SLP)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:BROOKE
Last Name:NIETO
Suffix:
Gender:F
Credentials:CF-SLP
Other - Prefix:
Other - First Name:ASHLEY
Other - Middle Name:BROOKE
Other - Last Name:PESEK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CF-SLP
Mailing Address - Street 1:326 SW 7TH ST
Mailing Address - Street 2:
Mailing Address - City:REDMOND
Mailing Address - State:OR
Mailing Address - Zip Code:97756-2205
Mailing Address - Country:US
Mailing Address - Phone:541-668-3232
Mailing Address - Fax:
Practice Address - Street 1:326 SW 7TH ST
Practice Address - Street 2:
Practice Address - City:REDMOND
Practice Address - State:OR
Practice Address - Zip Code:97756-2205
Practice Address - Country:US
Practice Address - Phone:541-668-3232
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-30
Last Update Date:2022-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist