Provider Demographics
NPI:1710713326
Name:GONZALEZ ARREDONDO, MARIA JOSE (MS CCC-SLP)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:JOSE
Last Name:GONZALEZ ARREDONDO
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 1:501 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:503-916-2641
Practice Address - Street 1:7439 N CHARLESTON AVE
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97203-3706
Practice Address - Country:US
Practice Address - Phone:503-916-6266
Practice Address - Fax:503-916-2641
Is Sole Proprietor?:No
Enumeration Date:2024-09-10
Last Update Date:2024-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR015371235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist