Basic Information
| Provider Information | |||||||||
| NPI: | 1013162874 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SIEBERS | ||||||||
| FirstName: | ROBERT | ||||||||
| MiddleName: | A. | ||||||||
| NamePrefix: | MR. | ||||||||
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| Credential: | BC-HIS | ||||||||
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| Mailing Information | |||||||||
| Address1: | 10395 NW GLENCOE RD STE 500 | ||||||||
| Address2: | |||||||||
| City: | NORTH PLAINS | ||||||||
| State: | OR | ||||||||
| PostalCode: | 971338223 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5036472095 | ||||||||
| FaxNumber: | 5036472096 | ||||||||
| Practice Location | |||||||||
| Address1: | 10395 NW GLENCOE RD STE 500 | ||||||||
| Address2: | |||||||||
| City: | NORTH PLAINS | ||||||||
| State: | OR | ||||||||
| PostalCode: | 971338223 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5036472095 | ||||||||
| FaxNumber: | 5036472096 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/20/2008 | ||||||||
| LastUpdateDate: | 06/18/2014 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 237700000X | HAS-P-225591 | OR | Y | Speech, Language and Hearing Service Providers | Hearing Instrument Specialist |
No ID Information.