Active NPI
Judith Likavec Davis, MS CCCSLP
- Speech-Language Pathologist
- Milwaukie, OR
National Provider Identifier
1659570604
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 11551
- Practice address
- 4560 SE International Way
Suite 100 Consonus Rehab Services
Milwaukie, OR 97222 - Phone
- (971) 206-5149
- Fax
- (971) 206-5209
- NPI assigned
- Jul 11, 2007
- 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 | 11551 | OR | Primary |
Addresses
Primary practice location
4560 SE International Way
Suite 100 Consonus Rehab Services
Milwaukie, OR 97222
Mailing address
4560 SE International Way
Suite 100 Consonus Rehab Services
Milwaukie, OR 97222
Phone (971) 206-5149
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 17011OMAP | Medicaid | OR |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11551 | OR | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1184112000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1205452800000",
"number": "1659570604",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4560 SE INTERNATIONAL WAY",
"address_2": "SUITE 100 CONSONUS REHAB SERVICES",
"city": "MILWAUKIE",
"state": "OR",
"postal_code": "97222",
"telephone_number": "971-206-5149",
"fax_number": "971-206-5209"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4560 SE INTERNATIONAL WAY",
"address_2": "SUITE 100 CONSONUS REHAB SERVICES",
"city": "MILWAUKIE",
"state": "OR",
"postal_code": "97222",
"telephone_number": "971-206-5149",
"fax_number": "971-206-5209"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "JUDITH",
"middle_name": "LIKAVEC",
"name_prefix": "Ms.",
"credential": "MS CCCSLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-07-11",
"last_updated": "2008-03-14",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "OR",
"license": "11551",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "17011OMAP",
"state": "OR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Milwaukie, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.