Provider Demographics
NPI:1962106104
Name:LAMB, MEREDITH KATHERINE ELAINE
Entity type:Individual
Prefix:
First Name:MEREDITH
Middle Name:KATHERINE ELAINE
Last Name:LAMB
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:618 E 1ST ST APT A
Mailing Address - Street 2:
Mailing Address - City:NEWBERG
Mailing Address - State:OR
Mailing Address - Zip Code:97132-2931
Mailing Address - Country:US
Mailing Address - Phone:714-514-6139
Mailing Address - Fax:
Practice Address - Street 1:14870 SW OSPREY CT STE 285
Practice Address - Street 2:
Practice Address - City:BEAVERTON
Practice Address - State:OR
Practice Address - Zip Code:97007-8616
Practice Address - Country:US
Practice Address - Phone:503-579-7327
Practice Address - Fax:503-974-0946
Is Sole Proprietor?:No
Enumeration Date:2023-03-30
Last Update Date:2023-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR17572235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist