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General NPI Number Information
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NPI Number | 1639107956
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Entity Type | Individual
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Provider Name | DENNIS O'LOUGHLIN AU.D.
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Gender | Male
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Dates
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Enumeration Date | 06/28/2006
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Last Update Date | 03/29/2010
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Provider Practice Location Address
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Address Line | 3857 WOLVERINE ST NE BUILDING C, SUITE 16
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City | SALEM
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State | OR
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Zip | 97305-4270
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Country | US
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Telephone | 503-588-1039
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Fax |
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Provider Business Mailing Address
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Address Line | 3857 WOLVERINE ST NE BUILDING C, SUITE 16
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City | SALEM
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State | OR
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Zip | 97305-4270
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Country | US
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Telephone | 503-588-1039
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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 | 22387
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License Number State | OR
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Taxonomy #2
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Taxonomy Code | 237700000X
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Taxonomy Name | Hearing Instrument Specialist
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License Number | HAS-P-051619
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License Number State | OR
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