Physician Compare National (NPI:1982956538)

HEALTHCARE PROVIDER: JESSICA RICHARDSON AU.D.

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1982956538
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	4587814728
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20121023000829
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	RICHARDSON
	Individual professional last name
Provider First Name	JESSICA
	Individual professional first name
Provider Gender	F
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	2012
	Individual professional's medical school graduation year
Primary Specialty	QUALIFIED AUDIOLOGIST
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	2740 19TH AVE
	Group Practice or individual's line 1 address
City	FOREST GROVE
	Group Practice or individual's city
State	OR
	Group Practice or individual's state
Zip Code	971162623
	Group Practice or individual's zip code (9 digits when available)
Phone Number	5033575050
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	Y