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General NPI Number Information
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NPI Number | 1124288386
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Entity Type | Individual
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Provider Name | PATRICIA LEE FLETTER AU.D, CCC-A
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Gender | Female
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Dates
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Enumeration Date | 06/11/2008
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Last Update Date | 10/19/2016
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Provider Practice Location Address
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Address Line | 2230 NW PETTYGROVE ST STE 120
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City | PORTLAND
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State | OR
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Zip | 97210-2659
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Country | US
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Telephone | 503-444-7676
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Fax | 971-319-6647
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Provider Business Mailing Address
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Address Line | 2230 NW PETTYGROVE ST STE 120
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City | PORTLAND
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State | OR
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Zip | 97210-2659
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Country | US
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Telephone | 503-444-7676
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Fax | 971-319-6647
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 231H00000X
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Taxonomy Name | Audiologist
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License Number | 22496
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License Number State | OR
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Taxonomy #2
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Taxonomy Code | 237700000X
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Taxonomy Name | Hearing Instrument Specialist
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License Number | HAS-P-388467
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License Number State | OR
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