Healthcare Provider Details

I. General information

NPI: 1336303445
Provider Name (Legal Business Name): PATRICIA MOISEME OYAKHIRE AUD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/17/2008
Last Update Date: 06/21/2021
Certification Date: 06/21/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4400 N 32ND ST STE 220
PHOENIX AZ
85018-3965
US

IV. Provider business mailing address

1010 E MCDOWELL RD STE LL1
PHOENIX AZ
85006-2606
US

V. Phone/Fax

Practice location:
  • Phone: 602-956-1250
  • Fax:
Mailing address:
  • Phone: 602-956-1250
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number80071
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: