Provider Demographics
NPI:1225916422
Name:AMOS, CAROLYN MARIE (MS, CF-SLP)
Entity type:Individual
Prefix:
First Name:CAROLYN
Middle Name:MARIE
Last Name:AMOS
Suffix:
Gender:F
Credentials:MS, CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 N DIXON ST
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97227-1876
Mailing Address - Country:US
Mailing Address - Phone:503-916-2000
Mailing Address - Fax:
Practice Address - Street 1:7900 SE DUKE ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97206-6337
Practice Address - Country:US
Practice Address - Phone:503-916-6373
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-25
Last Update Date:2025-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR18520235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist