Provider Demographics
NPI:1528527223
Name:BLASKOWSKY, ALLISON CLAIRE (MS, CF-SLP)
Entity type:Individual
Prefix:
First Name:ALLISON
Middle Name:CLAIRE
Last Name:BLASKOWSKY
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 1:17020 SW UPPER BOONES FERRY RD., SUITE 201
Mailing Address - Street 2:
Mailing Address - City:TIGARD
Mailing Address - State:OR
Mailing Address - Zip Code:97224
Mailing Address - Country:US
Mailing Address - Phone:503-894-1539
Mailing Address - Fax:503-210-1453
Practice Address - Street 1:17020 SW UPPER BOONES FERRY RD.
Practice Address - Street 2:SUITE 201
Practice Address - City:TIGARD
Practice Address - State:OR
Practice Address - Zip Code:97224
Practice Address - Country:US
Practice Address - Phone:503-894-1539
Practice Address - Fax:503-210-1453
Is Sole Proprietor?:No
Enumeration Date:2019-03-13
Last Update Date:2019-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR16387235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist