Healthcare Provider Details

I. General information

NPI: 1023263076
Provider Name (Legal Business Name): NORTLAND HEARING CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/18/2008
Last Update Date: 11/18/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2319 'K' STREET
SACRAMENTO CA
95816
US

IV. Provider business mailing address

10570 SE WASHINGTON ST. SUITE 202
PORTLAND OR
97216
US

V. Phone/Fax

Practice location:
  • Phone: 916-444-3790
  • Fax: 916-444-3793
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number
License Number State

VIII. Authorized Official

Name: MR. JEFF LEE LONGTAIN
Title or Position: PRESIDENT
Credential:
Phone: 503-257-6800