MEDICARE: NORTLAND HEARING CENTER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	237700000X	Hearing Instrument Specialist

General Provider Information

NPI Number	:	1023263076
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NORTLAND HEARING CENTER

Provider Business Mailing Address
First Line	:	10570 SE WASHINGTON ST.
Second Line	:	SUITE 202
City	:	PORTLAND
State	:	OR
Zip	:	97216
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2319 'K' STREET
Second Line	:
City	:	SACRAMENTO
State	:	CA
Zip	:	95816
Country	:	US
Telephone Number	:	916-444-3790
Fax Number	:	916-444-3793

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. JEFF LEE LONGTAIN
Credential	:
Telephone Number	:	503-257-6800

Provider Enumeration Date	:	11/18/2008
Last Update Date	:	11/18/2008

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Directions to “NORTLAND HEARING CENTER ” Practice Location

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