Healthcare Provider Details

I. General information

NPI: 1972634798
Provider Name (Legal Business Name): ONTARIO AUDIOLOGY & HEARING AIDS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/07/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1159 SW 4TH AVE
ONTARIO OR
97914-2129
US

IV. Provider business mailing address

1159 SW 4TH AVE
ONTARIO OR
97914-2129
US

V. Phone/Fax

Practice location:
  • Phone: 541-881-0970
  • Fax: 541-881-0971
Mailing address:
  • Phone: 541-881-0970
  • Fax: 541-881-0971

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number
License Number State

VIII. Authorized Official

Name: MRS. JODY D. ALEXANDER
Title or Position: CO-OWNER MANAGER
Credential:
Phone: 541-881-0970