=====================================================
General NPI Number Information
=====================================================
NPI Number | 1295615706
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MAEVE MARY KIRKPATRICK AUD
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/04/2025
-----------------------------------------------------
Last Update Date | 09/04/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 10024 SE 32ND AVE
-----------------------------------------------------
City | MILWAUKIE
-----------------------------------------------------
State | OR
-----------------------------------------------------
Zip | 97222-6514
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 503-513-8693
-----------------------------------------------------
Fax | 503-659-2191
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 10024 SE 32ND AVE
-----------------------------------------------------
City | MILWAUKIE
-----------------------------------------------------
State | OR
-----------------------------------------------------
Zip | 97222-6514
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 503-513-8693
-----------------------------------------------------
Fax | 503-659-2191
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 231H00000X
-----------------------------------------------------
Taxonomy Name | Audiologist
-----------------------------------------------------
License Number | 31147
-----------------------------------------------------
License Number State | OR
-----------------------------------------------------