Healthcare Provider Details

I. General information

NPI: 1972046787
Provider Name (Legal Business Name): AUDIOLOGY AND HEARING AID ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/28/2016
Last Update Date: 09/08/2025
Certification Date: 09/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1404 4TH ST
LA GRANDE OR
97850-2502
US

IV. Provider business mailing address

1404 4TH ST
LA GRANDE OR
97850-2502
US

V. Phone/Fax

Practice location:
  • Phone: 541-612-7555
  • Fax: 208-639-9581
Mailing address:
  • Phone: 208-761-8065
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number22401
License Number StateOR
# 2
Primary TaxonomyN
Taxonomy Code332S00000X
TaxonomyHearing Aid Equipment
License Number
License Number State

VIII. Authorized Official

Name: ERIKA SHAKESPEARE
Title or Position: OWNER/AUDIOLOGIST
Credential:
Phone: 541-612-7555