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General NPI Number Information
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NPI Number | 1467126748
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Entity Type | Individual
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Provider Name | BRIANNA RALSTON CHESSIK AUD
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Gender | Female
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Dates
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Enumeration Date | 08/02/2021
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Last Update Date | 04/17/2025
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Provider Practice Location Address
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Address Line | 1170 ROYAL AVE
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City | MEDFORD
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State | OR
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Zip | 97504-6101
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Country | US
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Telephone | 541-779-7331
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Fax |
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Provider Business Mailing Address
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Address Line | 1303 N EDISON PL UNIT B
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City | KENNEWICK
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State | WA
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Zip | 99336-1582
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Country | US
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Telephone | 503-713-9601
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Fax |
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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 | 30997
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License Number State | OR
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