Healthcare Provider Details

I. General information

NPI: 1184993214
Provider Name (Legal Business Name): ANTHONY MCLEAN HAS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/19/2011
Last Update Date: 12/19/2011
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

8800 SE SUNNYSIDE RD STE 300-N
CLACKAMAS OR
97015-5738
US

V. Phone/Fax

Practice location:
  • Phone: 503-591-7027
  • Fax:
Mailing address:
  • Phone: 503-659-5115
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License NumberHASP10135631
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: