Active NPI
Bethany Laratta, SLP
- Speech-Language Pathologist
- Gresham, OR
National Provider Identifier
1225783921
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 17139
- Practice address
- 304 NE Hood Ave
Gresham, OR 97030-7450 - Phone
- (503) 666-1333
- NPI assigned
- Feb 21, 2022
- Last updated
- Feb 21, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 17139 | OR | Primary |
Addresses
Primary practice location
304 NE Hood Ave
Gresham, OR 97030-7450
Mailing address
304 NE Hood Ave
Gresham, OR 97030-7450
Phone (503) 666-1333
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 17139 | Other | OR | STATE LICENSURE BOARD |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 17139 | OR | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1645401600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1645401600000",
"number": "1225783921",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "304 NE HOOD AVE",
"city": "GRESHAM",
"state": "OR",
"postal_code": "970307450",
"telephone_number": "503-666-1333"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "304 NE HOOD AVE",
"city": "GRESHAM",
"state": "OR",
"postal_code": "970307450",
"telephone_number": "503-666-1333"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LARATTA",
"first_name": "BETHANY",
"credential": "SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-02-21",
"last_updated": "2022-02-21",
"certification_date": "2022-02-21",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "OR",
"license": "17139",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENSURE BOARD",
"identifier": "17139",
"state": "OR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Gresham, OR
- Carol J Landesman, PH.D.
- Michelle Rebecca Landman, OTR
- Nicole Lane, RN
- Lar Ken Enterprises, Inc. (BestCare Hearing Aid Centers)
- Heather Danielle Lara, HEATHER BENNETT, M.A
- Christopher Larkin, OTD
- Greta Katherine Larson, ARNP
- Sydney Mariah Laschober, SLP
- Latrece Gaither, LLC
- Alexander Herman Lau, M.D.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.