Jill Kalat Dolata, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

12751 Issued in OR

Practice address

3181 SW Sam Jackson Park Rd
Mail Code: CDRC
Portland, OR 97239-3011

Phone

(503) 418-0689

NPI assigned

Aug 3, 2006

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)

Enrolled

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

{
    "created_epoch": "1154563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1186099200000",
    "number": "1851309322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 574",
            "address_2": "MAIL CODE: CDRC",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972070574",
            "telephone_number": "503-418-0689"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3181 SW SAM JACKSON PARK RD",
            "address_2": "MAIL CODE: CDRC",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972393011",
            "telephone_number": "503-418-0689"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOLATA",
        "first_name": "JILL",
        "middle_name": "KALAT",
        "credential": "CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-03",
        "last_updated": "2007-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "OR",
            "license": "12751",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Courtney Killeen Dolan, LMT# 26995
• Emily Dolan
• James Patrick Dolan, MD
• Jamie Marie Dolan
• Philip Jarvis Dolan, MD
• Melissa Dolbec, NP
• Jennifer Dole, D.M.D.
• Philbert Cosmas Doleac Jr., DDS
• Nicki Doler
• Leigh C Dolin, MD

• 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 3, 2007; 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.