Provider Demographics
NPI:1225211717
Name:LOPEZ, SYLVIA LYNN (SLP)
Entity type:Individual
Prefix:MRS
First Name:SYLVIA
Middle Name:LYNN
Last Name:LOPEZ
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:428 HEDIN TER
Mailing Address - Street 2:
Mailing Address - City:GASTON
Mailing Address - State:OR
Mailing Address - Zip Code:97119-7869
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3083 NE 49TH PL
Practice Address - Street 2:
Practice Address - City:HILLSBORO
Practice Address - State:OR
Practice Address - Zip Code:97124-6006
Practice Address - Country:US
Practice Address - Phone:503-844-1160
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-07
Last Update Date:2024-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZTSLP5694251300000X
OR015417235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
No251300000XAgenciesLocal Education Agency (LEA)