Provider Demographics
NPI:1316349194
Name:ANDRES, ANDRYCE (SLP, HEART SPEAK LLC)
Entity type:Individual
Prefix:
First Name:ANDRYCE
Middle Name:
Last Name:ANDRES
Suffix:
Gender:F
Credentials:SLP, HEART SPEAK LLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10223 SE 46TH AVE
Mailing Address - Street 2:
Mailing Address - City:MILWAUKIE
Mailing Address - State:OR
Mailing Address - Zip Code:97222-5208
Mailing Address - Country:US
Mailing Address - Phone:971-255-7377
Mailing Address - Fax:
Practice Address - Street 1:10223 SE 46TH AVE
Practice Address - Street 2:
Practice Address - City:MILWAUKIE
Practice Address - State:OR
Practice Address - Zip Code:97222-5208
Practice Address - Country:US
Practice Address - Phone:971-255-7377
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-23
Last Update Date:2022-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR15114235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist