1952291320 NPI number — INNEREAR BALANCE & HEARING CENTER LLC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1952291320 NPI number — INNEREAR BALANCE & HEARING CENTER LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
INNEREAR BALANCE & HEARING CENTER LLC
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:
Provider Other Organization Name Type Code:
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:
1952291320
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/08/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
10350 N VANCOUVER WAY (TEMPORARY ADDRESS)
Provider Second Line Business Mailing Address:
SUITE 63102
Provider Business Mailing Address City Name:
PORTLAND
Provider Business Mailing Address State Name:
OR
Provider Business Mailing Address Postal Code:
97217
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
616-214-9794
Provider Business Mailing Address Fax Number:
800-991-2996

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
10350 N VANCOUVER WAY (TEMPORARY ADDRESS)
Provider Second Line Business Practice Location Address:
SUITE 63102
Provider Business Practice Location Address City Name:
PORTLAND
Provider Business Practice Location Address State Name:
OR
Provider Business Practice Location Address Postal Code:
97217
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
616-214-9794
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/08/2025

Additional Information

Authorized Official

Authorized Official Last Name:
KURBAN
Authorized Official First Name:
FEBEN
Authorized Official Middle Name:
Authorized Official Title or Position:
AUDIOLOGIST
Authorized Official Telephone Number:
616-214-9794

Provider Taxonomy Codes

  • Taxonomy code: 231HA2400X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 231H00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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