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General NPI Number Information
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NPI Number | 1548343486
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Entity Type | Organization
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Legal Business Name | NORTHLAND HEARING CENTERS, INC
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Dates
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Enumeration Date | 10/23/2006
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Last Update Date | 06/13/2008
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Provider Practice Location Address
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Address Line | 289 E ELLENDALE AVE SUITE 602
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City | DALLAS
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State | OR
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Zip | 97338-1580
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Country | US
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Telephone | 503-831-1000
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Fax | 503-831-1331
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Provider Business Mailing Address
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Address Line | 289 E ELLENDALE AVE SUITE 602
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City | DALLAS
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State | OR
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Zip | 97338-1580
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Country | US
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Telephone | 503-831-1000
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Fax | 503-831-1331
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Authorized Official
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Title or Position | MANAGER
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Name | MR. BRADLEY P FORD
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Credential | B.S.
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Telephone | 503-831-1000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332S00000X
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Taxonomy Name | Hearing Aid Equipment
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License Number | HAS-P-817288
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License Number State | OR
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