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General NPI Number Information
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NPI Number | 1508396003
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Entity Type | Individual
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Provider Name | CHRISTA NICOLE DODSON AU.D.
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Gender | Female
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Dates
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Enumeration Date | 06/15/2017
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Last Update Date | 01/06/2023
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Provider Practice Location Address
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Address Line | 3181 SW SAM JACKSON PARK RD STE 250-36
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City | PORTLAND
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State | OR
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Zip | 97239-3011
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Country | US
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Telephone | 503-494-5171
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Fax |
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Provider Business Mailing Address
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Address Line | 4142 SE 52ND AVE
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City | PORTLAND
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State | OR
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Zip | 97206-3916
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Country | US
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Telephone | 360-581-3723
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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 | PENDING
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License Number State |
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