Kathleen Stacie Theilacker, AUD

NPI #1205348166 in Clackamas, Oregon

Provider Information

NPI Number: 1205348166
Entity Type: Individual
Name: Kathleen Stacie Theilacker, AUD
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Audiologist
Credential: AUD
Enumeration Date: Nov 1, 2017
Last Updated: Sep 14, 2022

Practice Location

Address: 9280 SE SUNNYBROOK BLVD STE 300
City: Clackamas
State: Oregon
ZIP Code: 97015-9353
Phone: (503) 233-5548

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist/Technologist - Speech-Language Assistant — Speech-Language Assistant	2355S0801X
Audiologist	231H00000X	Primary

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