Provider Demographics
NPI:1194458257
Name:GRIFFITH, CAROLYN ISABEL (MS CF-SLP)
Entity type:Individual
Prefix:
First Name:CAROLYN
Middle Name:ISABEL
Last Name:GRIFFITH
Suffix:
Gender:F
Credentials:MS CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4900 SW GRIFFITH DR STE 157
Mailing Address - Street 2:
Mailing Address - City:BEAVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97005-2977
Mailing Address - Country:US
Mailing Address - Phone:503-517-8555
Mailing Address - Fax:
Practice Address - Street 1:4900 SW GRIFFITH DR STE 157
Practice Address - Street 2:
Practice Address - City:BEAVERTON
Practice Address - State:OR
Practice Address - Zip Code:97005-2977
Practice Address - Country:US
Practice Address - Phone:503-517-8555
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-06
Last Update Date:2022-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR17535235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist