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Deactivated NPI 1528266954 Deactivated / Inactive NPI Male Practitioner

Gregory Keith Lilly , MS, CCC, SLP

Speech-Language Pathologist • Portland, OR

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Gregory Lilly has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date July 06, 2007
NPI Deactivation Date June 12, 2025
Total Practice Duration ~18 Years of Practice (2007 – 2025)

Professional Overview & Biography Verified Profile Summary

Gregory Lilly, MS, CCC, SLP was a registered Speech-Language Pathologist practicing in Portland, OR. Throughout an active medical career spanning 18 years, Gregory Lilly provided care at the practice location at 4326 SW KANAN DR until profile deactivation on 2025-06-12.

Practice Location & Contact Primary Location

Practice Address

4326 Sw Kanan Dr

Portland, OR 972213441

Telephone 5032454520

Specialty Benchmarks & Practice Insights

Comparative analytics for Speech-Language Pathologist in Portland, OR

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.0 Yrs
State Avg: 13.6 Yrs
Regional Practice Density
652 Specialists

Practicing in Portland, OR (2106 Statewide)

Telehealth Adoption Rate
0.2% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Speech-Language Pathologist Primary Specialty

NUCC Taxonomy Code: 235Z00000X

State License OR 11739

The speech-language pathologist is the professional who engages in clinical services, prevention, advocacy, education, administration, and research in the areas of communication and swallowing across the life span from infancy through geriatrics. Speech-language pathologists address typical and atypical impairments and disorders related to communication and swallowing in the areas of speech sound production, resonance, voice, fluency, language (comprehension and expression), cognition, and feeding and swallowing.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

1 Associated Practitioners
Katherine Kruse

Massage Therapist

NPI 1609168137

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated June 12, 2025

Record deactivated on June 12, 2025

NPI Profile Active July 08, 2007

NPI status registered as active in NPPES database

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Updated Practice Location July 08, 2007

Registered at 4326 SW KANAN DR, PORTLAND, OR 972213441 (Tel: 5032454520)

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Updated Business Mailing Address July 08, 2007

Registered at 4326 SW KANAN DR, PORTLAND, OR 972213441 (Tel: 5032454520)

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Provider Name / Credentials Updated July 08, 2007

Recorded as GREGORY LILLY, M.S., CCC, SLP

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Medical Taxonomy / Specialty Registered (Primary Specialty) July 08, 2007

Speech-Language Pathologist (License #11739 in OR)

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Initial NPI Registration & Enumeration July 06, 2007

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1528266954
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: July 06, 2007
Last Update: July 08, 2007
Deactivation Date: June 12, 2025

Mailing Address

4326 Sw Kanan Dr

Portland, OR 972213441

Phone: 5032454520

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.