Basic Information
| Provider Information | |||||||||
| NPI: | 1255467544 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | LEAGJELD'S REDMOND HEARING AID CENTER | ||||||||
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| Mailing Information | |||||||||
| Address1: | 106 SW 7TH ST | ||||||||
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| City: | REDMOND | ||||||||
| State: | OR | ||||||||
| PostalCode: | 977562110 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5415487011 | ||||||||
| FaxNumber: | 5415487023 | ||||||||
| Practice Location | |||||||||
| Address1: | 106 SW 7TH ST | ||||||||
| Address2: | |||||||||
| City: | REDMOND | ||||||||
| State: | OR | ||||||||
| PostalCode: | 977562110 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5415487011 | ||||||||
| FaxNumber: | 5415487023 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/23/2007 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | LEAGJELD | ||||||||
| AuthorizedOfficialFirstName: | JAMES | ||||||||
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| AuthorizedOfficialTitleorPosition: | OWNER, HEARING INSTRUMENT SPECIALIS | ||||||||
| AuthorizedOfficialTelephone: | 5415487011 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 237700000X | 0309027564 | OR | Y | 193400000X SINGLE SPECIALTY GROUP | Speech, Language and Hearing Service Providers | Hearing Instrument Specialist |
No ID Information.