Basic Information
| Provider Information | |||||||||
| NPI: | 1679895585 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | NORTHLAND HEARING CENTERS INC. | ||||||||
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| OtherOrganizationName: | MORTHWEST HEARING CENTERS | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 10570 SE WASHINGTON ST STE 210 | ||||||||
| Address2: | |||||||||
| City: | PORTLAND | ||||||||
| State: | OR | ||||||||
| PostalCode: | 972162846 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5032576800 | ||||||||
| FaxNumber: | 5032576810 | ||||||||
| Practice Location | |||||||||
| Address1: | 17891 SW TUALATIN VALLEY HWY | ||||||||
| Address2: | |||||||||
| City: | ALOHA | ||||||||
| State: | OR | ||||||||
| PostalCode: | 970064448 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5035917027 | ||||||||
| FaxNumber: | 5036429435 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/18/2010 | ||||||||
| LastUpdateDate: | 02/18/2010 | ||||||||
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| AuthorizedOfficialLastName: | MUNTZ | ||||||||
| AuthorizedOfficialFirstName: | JENNIFER | ||||||||
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| AuthorizedOfficialTitleorPosition: | MEDICAL BILLING SPECIALIST | ||||||||
| AuthorizedOfficialTelephone: | 5032576800 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2355A2700X | Y | 193200000X MULTI-SPECIALTY GROUP | Speech, Language and Hearing Service Providers | Specialist/Technologist | Audiology Assistant |
No ID Information.