Healthcare Provider Details

I. General information

NPI: 1699804211
Provider Name (Legal Business Name): BRIDGETOWN HEARING CLINIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/02/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

825 NE 20TH AVE SUITE 230
PORTLAND OR
97232-2275
US

IV. Provider business mailing address

825 NE 20TH AVE SUITE 230
PORTLAND OR
97232-2275
US

V. Phone/Fax

Practice location:
  • Phone: 503-528-6849
  • Fax: 503-234-4227
Mailing address:
  • Phone: 503-528-6849
  • Fax: 503-234-4227

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code231HA2400X
TaxonomyAssistive Technology Practitioner Audiologist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code231HA2500X
TaxonomyAssistive Technology Supplier Audiologist
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License Number
License Number State

VIII. Authorized Official

Name: RENATE N HART
Title or Position: OWNER-MANAGER
Credential:
Phone: 503-528-6849