Laura Louise Lillie, M.S., SLP-CCC

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

15617 Issued in OR

Practice address

15175 SW Bracken Fern CT
Sherwood, OR 97140-8490

Phone

(971) 330-7116

NPI assigned

Nov 6, 2017

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Laura L Archer Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1509926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696550400000",
    "number": "1912410432",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15175 SW BRACKEN FERN CT",
            "city": "SHERWOOD",
            "state": "OR",
            "postal_code": "971408490",
            "telephone_number": "971-330-7116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15175 SW BRACKEN FERN CT",
            "city": "SHERWOOD",
            "state": "OR",
            "postal_code": "971408490",
            "telephone_number": "971-330-7116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LILLIE",
        "first_name": "LAURA",
        "middle_name": "LOUISE",
        "credential": "M.S., SLP-CCC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-11-06",
        "last_updated": "2023-10-06",
        "certification_date": "2023-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "OR",
            "license": "15617",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500736248",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LAURA",
            "last_name": "ARCHER",
            "middle_name": "L",
            "credential": "MS CCC-SLP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Barbara Leitzinger
• Ian M Lentz, DO
• Aram Levendosky, L.AC.
• Peggy Ann Lewelling, RDH
• Elizabeth Lewis, PA-C
• Alaine Little, LMT
• Dean Ryan Longfellow, PSY.D.
• Blake Lowe, LMT
• Emily E Luis, D.P.T.
• Leatha Lorine Lynch, RPH, PHARMD

• Speech-Language Pathologist in Sherwood, OR
• Providers in Sherwood, 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 Oct 6, 2023; 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.