Healthcare Provider Details

I. General information

NPI: 1699059519
Provider Name (Legal Business Name): NORTHLAND HEARING CENTERS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/11/2011
Last Update Date: 05/09/2024
Certification Date: 05/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

63 W CENTER ST
OREM UT
84057-4605
US

IV. Provider business mailing address

8800 SE SUNNYSIDE RD STE 300-N
CLACKAMAS OR
97015-5738
US

V. Phone/Fax

Practice location:
  • Phone: 801-225-2222
  • Fax: 801-462-4867
Mailing address:
  • Phone: 503-659-5115
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QH0700X
TaxonomyHearing and Speech Clinic/Center
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: KATIE ANN KLEIN
Title or Position: MANAGER OF THIRD-PARTY PROGRAMS
Credential:
Phone: 952-999-5529