Pathway Speech Therapy LLC

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

15632 Issued in OR

Legal business name

PATHWAY SPEECH THERAPY LLC

Practice address

2035 SE Washington St
Milwaukie, OR 97222-7612

Phone

(503) 654-4959

Fax

(503) 437-9454

NPI assigned

Apr 16, 2018

Organization subpart

No

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

Authorized official

Name

Ellecia Grace Decouteau

Title

Owner

Phone

(503) 654-4959

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1523836800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1645574400000",
    "number": "1285121194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2035 SE WASHINGTON ST",
            "city": "MILWAUKIE",
            "state": "OR",
            "postal_code": "972227612",
            "telephone_number": "503-654-4959",
            "fax_number": "503-437-9454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2035 SE WASHINGTON ST",
            "city": "MILWAUKIE",
            "state": "OR",
            "postal_code": "972227612",
            "telephone_number": "503-654-4959",
            "fax_number": "503-437-9454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PATHWAY SPEECH THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-04-16",
        "last_updated": "2022-02-23",
        "certification_date": "2022-02-23",
        "status": "A",
        "authorized_official_last_name": "DECOUTEAU",
        "authorized_official_first_name": "ELLECIA",
        "authorized_official_middle_name": "GRACE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "503-654-4959"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "OR",
            "license": "15632",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500744169",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "R202809",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jennifer Rose Parr, FNP
• Heather Parson
• Pooja Parthasarathi, PHYSICAL THERAPIST
• Lori Pastoor, MS, CCC-SLP
• Romi Anish Patel
• Kevin Joseph Patrick, MS CCCSLP
• Rebecca Patton
• Paul D. Ruesch, MD PC
• Dianne Marie Paul
• Timothy Pavlatos, M.S.

• Speech-Language Pathologist in Milwaukie, OR
• Providers in Milwaukie, OR by specialty
• Speech-Language Pathologist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 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.

Verify at the official NPI Registry.