MEDICARE: JACOB PAUL TAUZIN HIS

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	HASP10154799	OR

General Provider Information

NPI Number	:	1235656265
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JACOB PAUL TAUZIN HIS

Provider Business Mailing Address
First Line	:	7901 SE POWELL BLVD
Second Line	:	STE B #185
City	:	PORTLAND
State	:	OR
Zip	:	97206-3105
Country	:	US
Telephone Number	:	971-266-3394
Fax Number	:

Provider Business Practice Location Address
First Line	:	5455 SE 91ST AVE
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97266-4603
Country	:	US
Telephone Number	:	971-266-3394
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/30/2017
Last Update Date	:	02/05/2020

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Directions to “ JACOB PAUL TAUZIN HIS” Practice Location

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