Active NPI
Angela Fidler, M.S. CF-SLP
- Speech-Language Pathologist
- Portland, OR
National Provider Identifier
1780448654
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 18097
- Practice address
- 1610 SE Glenwood St
Portland, OR 97202-5615 - Phone
- (503) 927-3598
- NPI assigned
- Feb 12, 2024
- Sex
- Female
- Sole proprietor
- Yes
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 | 18097 | OR | Primary |
Addresses
Primary practice location
1610 SE Glenwood St
Portland, OR 97202-5615
Mailing address
4500 NW 9TH Cir
Camas, WA 98607-7918
Phone (360) 771-6919
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 |
|---|---|---|---|
| 18097 | OR | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1707696000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1707696000000",
"number": "1780448654",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4500 NW 9TH CIR",
"city": "CAMAS",
"state": "WA",
"postal_code": "986077918",
"telephone_number": "360-771-6919"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1610 SE GLENWOOD ST",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972025615",
"telephone_number": "503-927-3598"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FIDLER",
"first_name": "ANGELA",
"name_prefix": "Mrs.",
"credential": "M.S. CF-SLP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-02-12",
"last_updated": "2024-02-12",
"certification_date": "2024-02-09",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "OR",
"license": "18097",
"primary": true
}
],
"identifiers": [],
"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 Feb 12, 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.