Healthcare Provider Details

I. General information

NPI: 1982984662
Provider Name (Legal Business Name): HEARING ASSISTANCE TECHNOLOGY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/25/2011
Last Update Date: 07/16/2024
Certification Date: 07/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

975 NW SPRUCE AVE STE 102
CORVALLIS OR
97330-2297
US

IV. Provider business mailing address

475 I ST
INDEPENDENCE OR
97351-1820
US

V. Phone/Fax

Practice location:
  • Phone: 541-754-1377
  • Fax: 541-754-9192
Mailing address:
  • Phone: 503-838-2838
  • Fax: 503-838-6531

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number20698
License Number StateOR
# 2
Primary TaxonomyN
Taxonomy Code261QH0700X
TaxonomyHearing and Speech Clinic/Center
License Number20698
License Number StateOR

VIII. Authorized Official

Name: BRYCE KNOTT
Title or Position: DIRECTOR OF OPERATIONS
Credential:
Phone: 541-754-1377