1861705154 NPI number — NORTHLAND HEARING CENTERS INC

Table of content: HEATHER KAY YACKO M.S. R.D. L.D.N (NPI 1154560910)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1861705154 NPI number — NORTHLAND HEARING CENTERS INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NORTHLAND HEARING CENTERS INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
ALL AMERICAN HEARING
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1861705154
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/15/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
10570 SE WASHINGTON ST
Provider Second Line Business Mailing Address:
SUITE 210
Provider Business Mailing Address City Name:
PORTLAND
Provider Business Mailing Address State Name:
OR
Provider Business Mailing Address Postal Code:
97216-2846
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
503-257-6800
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
51 E 400 N
Provider Second Line Business Practice Location Address:
SUITE 4A
Provider Business Practice Location Address City Name:
CEDAR CITY
Provider Business Practice Location Address State Name:
UT
Provider Business Practice Location Address Postal Code:
84721-6186
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
801-334-0421
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/15/2010

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
NELSON
Authorized Official First Name:
SCOTT
Authorized Official Middle Name:
Authorized Official Title or Position:
VP FINANCE
Authorized Official Telephone Number:
952-828-9120

Provider Taxonomy Codes

  • Taxonomy code: 231H00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 237600000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 237700000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)