Provider Demographics
NPI:1750872396
Name:SENGER, KAYLIE E LYNN
Entity type:Individual
Prefix:
First Name:KAYLIE
Middle Name:E LYNN
Last Name:SENGER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13410 OLD WOODS RD
Mailing Address - Street 2:
Mailing Address - City:CLOVERDALE
Mailing Address - State:OR
Mailing Address - Zip Code:97112-9464
Mailing Address - Country:US
Mailing Address - Phone:503-457-8807
Mailing Address - Fax:
Practice Address - Street 1:2844 RIDGEWAY DR SE
Practice Address - Street 2:
Practice Address - City:TURNER
Practice Address - State:OR
Practice Address - Zip Code:97392-9570
Practice Address - Country:US
Practice Address - Phone:541-913-4770
Practice Address - Fax:877-795-6145
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-18
Last Update Date:2018-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR16147235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR16147OtherOREGON BOARD OF EXAMINERS FOR SPEECH LANGUAGE PATHOLOGY