Basic Information
| Provider Information | |||||||||
| NPI: | 1386082535 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | DRULLINGER | ||||||||
| FirstName: | LEAH | ||||||||
| MiddleName: | PAIGE | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | AUD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1939 E BURNSIDE ST | ||||||||
| Address2: | |||||||||
| City: | PORTLAND | ||||||||
| State: | OR | ||||||||
| PostalCode: | 972141535 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5032336141 | ||||||||
| FaxNumber: | 8774329940 | ||||||||
| Practice Location | |||||||||
| Address1: | 1939 E BURNSIDE ST | ||||||||
| Address2: | |||||||||
| City: | PORTLAND | ||||||||
| State: | OR | ||||||||
| PostalCode: | 972141535 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5032336141 | ||||||||
| FaxNumber: | 8774329940 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/10/2013 | ||||||||
| LastUpdateDate: | 10/30/2013 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 237600000X | 22106 | OR | Y | Speech, Language and Hearing Service Providers | Audiologist-Hearing Aid Fitter |
No ID Information.