Provider Demographics
NPI:1093555005
Name:TOPAUM, SHARLA (SLP-CCC)
Entity type:Individual
Prefix:
First Name:SHARLA
Middle Name:
Last Name:TOPAUM
Suffix:
Gender:F
Credentials:SLP-CCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4332 SE 31ST ST
Mailing Address - Street 2:
Mailing Address - City:GRESHAM
Mailing Address - State:OR
Mailing Address - Zip Code:97080-6418
Mailing Address - Country:US
Mailing Address - Phone:503-502-7201
Mailing Address - Fax:
Practice Address - Street 1:18009 SE BROOKLYN ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97236-1047
Practice Address - Country:US
Practice Address - Phone:503-762-3208
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-28
Last Update Date:2024-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR124526235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist