Individual provider Active NPI

Amy Smalley, MS,CCC-SLP

  • Speech-Language Pathologist
  • Lake Oswego, OR
National Provider Identifier
1104359736
Registry record updated Apr 11, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
Practice address
4550 Carman Dr
Lake Oswego, OR 97035-2520
Phone
(503) 675-6055
NPI assigned
Apr 11, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X Primary

Addresses

Primary practice location

4550 Carman Dr
Lake Oswego, OR 97035-2520

Mailing address

25117 SW Parkway Ave
Ste D
Wilsonville, OR 97070-9697

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Science

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1491868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1491868800000",
    "number": "1104359736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25117 SW PARKWAY AVE",
            "address_2": "STE D",
            "city": "WILSONVILLE",
            "state": "OR",
            "postal_code": "970709697"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4550 CARMAN DR",
            "city": "LAKE OSWEGO",
            "state": "OR",
            "postal_code": "970352520",
            "telephone_number": "503-675-6055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMALLEY",
        "first_name": "AMY",
        "credential": "MS,CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-11",
        "last_updated": "2017-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Oswego, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.