Provider Demographics
NPI:1548009178
Name:HASTINGS, ALISON JEAN (MA, CCC-SLP)
Entity type:Individual
Prefix:MS
First Name:ALISON
Middle Name:JEAN
Last Name:HASTINGS
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3955 SE 112TH AVE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97266-1734
Mailing Address - Country:US
Mailing Address - Phone:503-256-6519
Mailing Address - Fax:
Practice Address - Street 1:3955 SE 112TH AVE
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97266-1734
Practice Address - Country:US
Practice Address - Phone:503-256-6519
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-22
Last Update Date:2024-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR012776235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist