Active NPI
Amanda Corr, LMT, SLP
- Speech-Language Pathologist
- Portland, OR
National Provider Identifier
1760786438
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 18311
- Practice address
- 6165 NE Alton St
Portland, OR 97213-3219 - Phone
- (503) 680-0900
- NPI assigned
- Jan 10, 2011
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | 14579 | OR | |
| Speech-Language Pathologist | 235Z00000X | 18311 | OR | Primary |
Addresses
Primary practice location
6165 NE Alton St
Portland, OR 97213-3219
Mailing address
6832 NE Claremont Ave
Portland, OR 97211-4042
Phone (503) 680-0900
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 18311 | Other | OR | OREGON BOARD OF SPEECH LANGUAGE PATHOLOGY |
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 |
|---|---|---|---|
| 14579 | OR | MD | Massage Therapist |
| 18311 | OR | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1294617600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1725494400000",
"number": "1760786438",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6832 NE CLAREMONT AVE",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972114042",
"telephone_number": "503-680-0900"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6165 NE ALTON ST",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972133219",
"telephone_number": "503-680-0900"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CORR",
"first_name": "AMANDA",
"credential": "LMT, SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-01-10",
"last_updated": "2024-09-05",
"certification_date": "2024-09-05",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "OR",
"license": "14579",
"primary": false
},
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "OR",
"license": "18311",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OREGON BOARD OF SPEECH LANGUAGE PATHOLOGY",
"identifier": "18311",
"state": "OR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Portland, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.