Mallary Ellyn Owen, MS CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

17365 Issued in OR

Practice address

17020 SW Upper Boones Ferry Rd Ste 201
Portland, OR 97224-7078

Phone

(503) 894-1539

NPI assigned

Aug 25, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

Practice roles

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.

• Parkwood Clinic LLC

  • Speech-Language Pathologist
  • Portland, OR
  • NPI 1124469325
  NPD (past)

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

{
    "created_epoch": "1661385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661385600000",
    "number": "1689393282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6146 SW 46TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972212818",
            "telephone_number": "602-616-8248"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17020 SW UPPER BOONES FERRY RD STE 201",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972247078",
            "telephone_number": "503-894-1539"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OWEN",
        "first_name": "MALLARY",
        "middle_name": "ELLYN",
        "credential": "MS CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-25",
        "last_updated": "2022-08-25",
        "certification_date": "2022-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "OR",
            "license": "17365",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Carol Owen, MOT
• Jennifer G Owen, N.P.
• Jessica L Owen, DPT
• Kelly Owen
• Liane Owen, L.AC.
• Tamara Owen, PMHNP
• Zeth M. Owen
• Elizah A Owens, RPH
• Gabriel P Owens, PA-C
• Gregory Owens Jr.

• Speech-Language Pathologist in Portland, OR
• Providers in Portland, 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 Aug 25, 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.