NPIMap

Sarah E Burgon, SLP

Individual provider Active NPI Speech-Language Pathologist · Canby, OR

NPI 1962540153 · NPPES record last updated Feb 13, 2020

Key facts

NPI
1962540153
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
013412 (OR)
Practice address
366 N Holly St
Canby, OR 97013-3739
Phone
(503) 266-1030
Fax
(971) 244-9044
NPI assigned
Feb 1, 2007
Sex
Female
Sole proprietor
Yes

Organizations & group practices 1

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.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
013412ORMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Sunbreak Therapy Services, Inc Speech-Language Pathologist Current
since Mar 9, 2020		 Accepting new patients

Locations

8700 SW Creekside Pl
Ste B
Beaverton, OR 97008
Phone (503) 224-2184

366 N Holly St
Canby, OR 97013
Phone (503) 266-1030

6516 NE Siskiyou St
Portland, OR 97213
Phone (503) 266-1030

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 013412 OR Yes

Addresses

Primary practice location

366 N Holly St
Canby, OR 97013-3739

Mailing address

PO Box 946
Canby, OR 97013-0946
Phone (503) 266-1030

Other providers in Canby, OR

All providers in Canby, OR · Speech-Language Pathologist in Oregon

Sources for this page

Verify at the official NPI Registry.