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NPI Code Detail

MEDICARE: NORTHLAND HEARING CENTER INC

MEDICARE: NORTHLAND HEARING CENTER INC
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
1237600000XAudiologist-Hearing Aid Fitter7479MN

General Provider Information

NPI Number : 1033403464
Entity Type Code : Organization
Provider Name (Legal Business Name) : NORTHLAND HEARING CENTER INC
Provider Business Mailing Address
First Line : 8800 SE SUNNYSIDE RD
Second Line : STE. 300-N
City : CLACKAMAS
State : OR
Zip : 97015-5738
Country : US
Telephone Number : 503-659-5115
Fax Number : 866-448-6830
Provider Business Practice Location Address
First Line : 12170 ABERDEEN ST NE
Second Line :
City : BLAINE
State : MN
Zip : 55449-4716
Country : US
Telephone Number : 763-795-6047
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : MR. JEFFREY LONGTAIN
Credential :
Telephone Number : 503-659-5115
Provider Enumeration Date : 06/02/2011
Last Update Date : 06/02/2011

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Directions to “NORTHLAND HEARING CENTER INC ” Practice Location

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