Basic Information
| Provider Information | |||||||||
| NPI: | 1851603351 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | LEAGJELD | ||||||||
| FirstName: | JAMES | ||||||||
| MiddleName: | ALAN | ||||||||
| NamePrefix: | MR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | LICENSED OREGON HEAR | ||||||||
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| Mailing Information | |||||||||
| Address1: | 932 N.E. 3RD ST. | ||||||||
| Address2: | |||||||||
| City: | BEND | ||||||||
| State: | OR | ||||||||
| PostalCode: | 97701 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5413823308 | ||||||||
| FaxNumber: | 5413180767 | ||||||||
| Practice Location | |||||||||
| Address1: | 106 S.W. 7TH ST. | ||||||||
| Address2: | |||||||||
| City: | REDMOND | ||||||||
| State: | OR | ||||||||
| PostalCode: | 97756 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5415487011 | ||||||||
| FaxNumber: | 5415487023 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/13/2010 | ||||||||
| LastUpdateDate: | 07/13/2010 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 237700000X | HAS-P-027564 | OR | Y | Speech, Language and Hearing Service Providers | Hearing Instrument Specialist |
No ID Information.