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General NPI Number Information
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NPI Number | 1801828306
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Entity Type | Organization
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Legal Business Name | PORTLAND AUDIOLOGY, INC
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Dates
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Enumeration Date | 07/07/2006
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Last Update Date | 02/25/2022
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Provider Practice Location Address
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Address Line | 1849 NW KEARNEY ST STE 202
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City | PORTLAND
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State | OR
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Zip | 97209-1453
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Country | US
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Telephone | 503-222-3638
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Fax | 503-223-5139
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Provider Business Mailing Address
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Address Line | 1849 NW KEARNEY ST STE 202
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City | PORTLAND
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State | OR
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Zip | 97209-1453
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Country | US
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Telephone | 503-222-3638
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Fax | 503-223-5139
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Authorized Official
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Title or Position | OWNER
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Name | DR. ALISON METCALF
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Credential | AU.D
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Telephone | 503-222-3638
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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 | 22223
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License Number State | OR
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