Provider Demographics
NPI:1215785845
Name:BARCLIFT, ANGELA JOY (MS, CF-SLP)
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:JOY
Last Name:BARCLIFT
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 1:6975 N MARYLAND AVE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97217-5423
Mailing Address - Country:US
Mailing Address - Phone:616-706-0408
Mailing Address - Fax:
Practice Address - Street 1:6975 N MARYLAND AVE
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97217-5423
Practice Address - Country:US
Practice Address - Phone:616-706-0408
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-08
Last Update Date:2024-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR18095235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist