Basic Information
| Provider Information | |||||||||
| NPI: | 1407137581 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | NORTHLAND HEARING CENTERS, INC. | ||||||||
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| OtherOrganizationName: | SOUNDPOINT AUDIOLOGY | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8800 SE SUNNYSIDE RD | ||||||||
| Address2: | STE. 300-N | ||||||||
| City: | CLACKAMAS | ||||||||
| State: | OR | ||||||||
| PostalCode: | 970155738 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5036595115 | ||||||||
| FaxNumber: | 5036595968 | ||||||||
| Practice Location | |||||||||
| Address1: | 2600 S RAINBOW BLVD | ||||||||
| Address2: | STE. 105 | ||||||||
| City: | LAS VEGAS | ||||||||
| State: | NV | ||||||||
| PostalCode: | 891464006 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7023623138 | ||||||||
| FaxNumber: | 7023629983 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/02/2011 | ||||||||
| LastUpdateDate: | 09/02/2011 | ||||||||
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| AuthorizedOfficialLastName: | LONGTAIN | ||||||||
| AuthorizedOfficialFirstName: | JEFFERY | ||||||||
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| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 5036595115 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 237700000X | N20061148428 | NV | N | 193200000X MULTI-SPECIALTY GROUP | Speech, Language and Hearing Service Providers | Hearing Instrument Specialist | 237600000X | NV20061148428 | NV | Y | 193200000X MULTI-SPECIALTY GROUP | Speech, Language and Hearing Service Providers | Audiologist-Hearing Aid Fitter |
No ID Information.