Provider Demographics
NPI:1811443054
Name:VEENKAMP, CHRISTIE (MA, CCC/SLP)
Entity type:Individual
Prefix:
First Name:CHRISTIE
Middle Name:
Last Name:VEENKAMP
Suffix:
Gender:F
Credentials:MA, CCC/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9155 SW BARNES ROAD
Mailing Address - Street 2:EAST PAVILION - PCDI (PROV CHILDREN'S DEVEL. INSTITUTE)
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97225
Mailing Address - Country:US
Mailing Address - Phone:503-215-0241
Mailing Address - Fax:503-216-6813
Practice Address - Street 1:9155 SW BARNES RD
Practice Address - Street 2:EAST PAVILION - PCDI (PROV CHILDREN'S DEVEL. INSTITUTE)
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97225-6625
Practice Address - Country:US
Practice Address - Phone:503-215-0241
Practice Address - Fax:503-216-6813
Is Sole Proprietor?:No
Enumeration Date:2016-08-28
Last Update Date:2021-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR11879235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist