Basic Information
Provider Information
NPI: 1588718217
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: COHOE
FirstName: NORA
MiddleName: DIANE
NamePrefix:  
NameSuffix:  
Credential: SPEECH LANGUAGE PATH
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: COHOE
OtherFirstName: NORA
OtherMiddleName: DIANE
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType: 5
Mailing Information
Address1: 4560 SE INTERNATIONAL WAY
Address2:  
City: MILWAUKIE
State: OR
PostalCode: 97222
CountryCode: US
TelephoneNumber: 9712065140
FaxNumber: 9712065209
Practice Location
Address1: 4560 SE INTERNATIONAL WAY
Address2: CONSONUS REHAB SERVICES
City: MILWAUKIE
State: OR
PostalCode: 97222
CountryCode: US
TelephoneNumber: 9712065140
FaxNumber: 9712065209
Other Information
ProviderEnumerationDate: 01/22/2007
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
235Z00000X12514ORY Speech, Language and Hearing Service ProvidersSpeech-Language Pathologist 

No ID Information.


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