Provider Demographics
NPI:1700504511
Name:HANEL SAUTTER SPEECH & LANGUAGE
Entity type:Organization
Organization Name:HANEL SAUTTER SPEECH & LANGUAGE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:VERONICA
Authorized Official - Middle Name:MARY
Authorized Official - Last Name:SAUTTER
Authorized Official - Suffix:
Authorized Official - Credentials:SLP
Authorized Official - Phone:503-713-9770
Mailing Address - Street 1:1340 SW BERTHA BLVD STE 202
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97219-2172
Mailing Address - Country:US
Mailing Address - Phone:503-713-9770
Mailing Address - Fax:425-697-9884
Practice Address - Street 1:1340 SW BERTHA BLVD STE 202
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97219-2172
Practice Address - Country:US
Practice Address - Phone:503-713-9770
Practice Address - Fax:425-697-9884
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-17
Last Update Date:2022-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR1720358815OtherSPEECH-LANGUAGE PATHOLOGY