Basic Information
Provider Information
NPI: 1437205432
EntityType: 2
ReplacementNPI:  
OrganizationName: NORTHLAND HEARING CENTERS, INC
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName: ALL AMERICAN HEARING AIDS
OtherOrganizationType: 3
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 10570 SE WASHINGTON ST
Address2: SUITE 202
City: PORTLAND
State: OR
PostalCode: 972162846
CountryCode: US
TelephoneNumber: 5032576800
FaxNumber: 5032576810
Practice Location
Address1: 1153 NILES CORTLAND RD SE
Address2:  
City: WARREN
State: OH
PostalCode: 444842542
CountryCode: US
TelephoneNumber: 3303473000
FaxNumber: 3303730008
Other Information
ProviderEnumerationDate: 01/25/2007
LastUpdateDate: 08/22/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: NELSON
AuthorizedOfficialFirstName: SCOTT
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition: VP FINANCE
AuthorizedOfficialTelephone: 9528289120
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
231H00000X  X193400000X MULTIPLE SINGLE SPECIALTY GROUPSpeech, Language and Hearing Service ProvidersAudiologist 
237700000X  X193400000X MULTIPLE SINGLE SPECIALTY GROUPSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist 

No ID Information.


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