Healthcare Provider Details

I. General information

NPI: 1497179717
Provider Name (Legal Business Name): PACIFIC UNIVERSITY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/06/2014
Last Update Date: 11/14/2023
Certification Date: 11/14/2023
Deactivation Date: 10/28/2021
Reactivation Date: 11/15/2021

III. Provider practice location address

333 SE 7TH AVE STE 4450
HILLSBORO OR
97123-4157
US

IV. Provider business mailing address

333 SE 7TH AVE STE 4150
HILLSBORO OR
97123-4157
US

V. Phone/Fax

Practice location:
  • Phone: 360-352-2692
  • Fax: 503-924-6704
Mailing address:
  • Phone: 503-352-2692
  • Fax: 503-924-6704

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License NumberLD00001627
License Number StateOR

VIII. Authorized Official

Name: LISA DOWNING
Title or Position: COMPLIANCE OFFICER
Credential:
Phone: 503-352-2663