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General NPI Number Information
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NPI Number | 1366802274
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Entity Type | Organization
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Legal Business Name | AUDIOLOGY ASSOCIATES
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Dates
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Enumeration Date | 03/04/2016
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Last Update Date | 03/04/2016
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Provider Practice Location Address
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Address Line | 2296 NW KINGS BLVD SUITE 102
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City | CORVALLIS
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State | OR
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Zip | 97330-3899
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Country | US
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Telephone | 541-757-2500
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Fax | 541-757-3001
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Provider Business Mailing Address
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Address Line | 1343A MONMOUTH ST
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City | INDEPENDENCE
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State | OR
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Zip | 97351-1100
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Country | US
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Telephone | 503-838-3001
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Fax | 503-838-0994
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Authorized Official
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Title or Position | OWNER
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Name | EVAN L EVANS
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Credential | PHD, AUD
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Telephone | 541-757-2500
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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 | 30205
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License Number State | OR
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