Healthcare Provider Details

I. General information

NPI: 1679895585
Provider Name (Legal Business Name): NORTHLAND HEARING CENTERS INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/18/2010
Last Update Date: 02/18/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17891 SW TUALATIN VALLEY HWY
ALOHA OR
97006-4448
US

IV. Provider business mailing address

10570 SE WASHINGTON ST STE 210
PORTLAND OR
97216-2846
US

V. Phone/Fax

Practice location:
  • Phone: 503-591-7027
  • Fax: 503-642-9435
Mailing address:
  • Phone: 503-257-6800
  • Fax: 503-257-6810

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2355A2700X
TaxonomyAudiology Assistant
License Number
License Number State

VIII. Authorized Official

Name: JENNIFER MUNTZ
Title or Position: MEDICAL BILLING SPECIALIST
Credential:
Phone: 503-257-6800