Heather Ann Ballou Wells, M.A., CCC-SLP

Individual provider Active NPI Speech-Language Pathologist · Gresham, OR

NPI 1467201277 · NPPES record last updated May 14, 2024

Key facts

NPI
1467201277
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
011965 (OR)
Practice address
1331 NW Eastman Pkwy
Gresham, OR 97030-3896
Phone
(503) 264-4653
Fax
(503) 261-4669
NPI assigned
May 14, 2024
Sex
Female
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
011965ORMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Multnomah County School District #U2-20JT Past
since May 19, 2024
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 011965 OR Yes

Addresses

Primary practice location

1331 NW Eastman Pkwy
Gresham, OR 97030-3896

Mailing address

39995 Mitchell CT
Sandy, OR 97055-9318
Phone (503) 914-7761

Other providers in Gresham, OR

All providers in Gresham, OR · Speech-Language Pathologist in Oregon

Sources for this page

Verify at the official NPI Registry.