Provider Demographics
NPI:1801787338
Name:HORNUNG, MELISSA (CCC-SLP)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:
Last Name:HORNUNG
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27 TANGLEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:LAKE OSWEGO
Mailing Address - State:OR
Mailing Address - Zip Code:97035-1417
Mailing Address - Country:US
Mailing Address - Phone:719-649-0413
Mailing Address - Fax:
Practice Address - Street 1:23839 SW DANIEL RD
Practice Address - Street 2:
Practice Address - City:BEAVERTON
Practice Address - State:OR
Practice Address - Zip Code:97078-5400
Practice Address - Country:US
Practice Address - Phone:503-217-2058
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-12
Last Update Date:2025-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR17215235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty