Provider Demographics
NPI:1063601706
Name:MURPHY, ANNMARIE BAUER (MS)
Entity type:Individual
Prefix:
First Name:ANNMARIE
Middle Name:BAUER
Last Name:MURPHY
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3816 SE 33RD AVE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97202-3029
Mailing Address - Country:US
Mailing Address - Phone:503-236-4969
Mailing Address - Fax:
Practice Address - Street 1:3816 SE 33RD AVE
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97202-3029
Practice Address - Country:US
Practice Address - Phone:503-236-4969
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-18
Last Update Date:2007-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR12946235Z00000X
WALL00004667235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist