1023425865 NPI number — NORTHLAND HEARING CENTERS, INC.

Table of content: (NPI 1023425865)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1023425865 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:
ASCENT HEARING & AUDIOLOGY
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:
1023425865
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/18/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
8800 SE SUNNYSIDE RD
Provider Second Line Business Mailing Address:
SUITE 300 N
Provider Business Mailing Address City Name:
CLACKAMAS
Provider Business Mailing Address State Name:
OR
Provider Business Mailing Address Postal Code:
97015-5738
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
281-281-2999
Provider Business Mailing Address Fax Number:
512-607-4893

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
19415 DEERFIELD AVE
Provider Second Line Business Practice Location Address:
SUITE 301-B
Provider Business Practice Location Address City Name:
LANSDOWNE
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
20176-8452
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
703-723-9672
Provider Business Practice Location Address Fax Number:
703-724-0127
Provider Enumeration Date:
07/14/2014

Additional Information

Authorized Official

Authorized Official Last Name:
WINCHESTER
Authorized Official First Name:
MELONY
Authorized Official Middle Name:
Authorized Official Title or Position:
SR. DIRECTOR OF RETAIL OPERATIONS
Authorized Official Telephone Number:
503-659-5115

Provider Taxonomy Codes

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

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





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