Provider Demographics
NPI:1871051623
Name:ANDREWS, JESSICA LYNN (MS CCC, SLP)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:LYNN
Last Name:ANDREWS
Suffix:
Gender:F
Credentials:MS CCC, SLP
Other - Prefix:
Other - First Name:JESSICA
Other - Middle Name:LYNN
Other - Last Name:RAU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5055 NW COYNER AVE
Mailing Address - Street 2:
Mailing Address - City:REDMOND
Mailing Address - State:OR
Mailing Address - Zip Code:97756-9357
Mailing Address - Country:US
Mailing Address - Phone:541-280-6482
Mailing Address - Fax:
Practice Address - Street 1:3000 SW 32ND ST
Practice Address - Street 2:
Practice Address - City:REDMOND
Practice Address - State:OR
Practice Address - Zip Code:97756-8321
Practice Address - Country:US
Practice Address - Phone:541-923-5452
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-11
Last Update Date:2019-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR013416235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist