Healthcare Provider Details

I. General information

NPI: 1285153841
Provider Name (Legal Business Name): JADE KUHL AU.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/14/2017
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2521 BOONE RD SE STE 120
SALEM OR
97306-9391
US

IV. Provider business mailing address

2521 BOONE RD SE STE 120
SALEM OR
97306-9391
US

V. Phone/Fax

Practice location:
  • Phone: 971-701-6322
  • Fax:
Mailing address:
  • Phone: 971-701-6322
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License Number30893
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: