Provider Demographics
NPI:1538425640
Name:BOYER, ANGELA MAUREEN (MS CCC-SLP)
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:MAUREEN
Last Name:BOYER
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 1:10313 SW DENNEY RD
Mailing Address - Street 2:
Mailing Address - City:BEAVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97008-6017
Mailing Address - Country:US
Mailing Address - Phone:971-645-5679
Mailing Address - Fax:
Practice Address - Street 1:10313 SW DENNEY RD
Practice Address - Street 2:
Practice Address - City:BEAVERTON
Practice Address - State:OR
Practice Address - Zip Code:97008-6017
Practice Address - Country:US
Practice Address - Phone:971-645-5679
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-03
Last Update Date:2012-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR12692235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist