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NPI Code Detail

MEDICARE: NORTHLAND HEARING CENTERS, INC.

MEDICARE: NORTHLAND HEARING CENTERS, 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
1237700000XHearing Instrument SpecialistW15256220-01HI
2231H00000XAudiologistW15256220-01HI

General Provider Information

NPI Number : 1942552740
Entity Type Code : Organization
Provider Name (Legal Business Name) : NORTHLAND HEARING CENTERS, 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 : 503-659-5887
Provider Business Practice Location Address
First Line : 1401 SOUTH BERETANIA STREET
Second Line : SUITE 330
City : HONOLULU
State : HI
Zip : 96817-1872
Country : US
Telephone Number : 808-536-5797
Fax Number : 808-536-3237
Authorized Official
Title or Position : PRESIDENT
Name : MR. JEFFREY LONGTAIN
Credential :
Telephone Number : 503-659-5115
Provider Enumeration Date : 10/04/2012
Last Update Date : 10/04/2012

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Directions to “NORTHLAND HEARING CENTERS, INC. ” Practice Location

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