Healthcare Provider Details

I. General information

NPI: 1831508720
Provider Name (Legal Business Name): JOEL SNAIR
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/05/2014
Last Update Date: 08/05/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4340 SW 110TH AVE
BEAVERTON OR
97005-3014
US

IV. Provider business mailing address

4340 SW 110TH AVE
BEAVERTON OR
97005-3014
US

V. Phone/Fax

Practice location:
  • Phone: 503-597-3020
  • Fax: 503-597-3023
Mailing address:
  • Phone: 503-597-3020
  • Fax: 503-597-3023

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License NumberHAS-P-10130664
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: