Provider Demographics
NPI:1083384911
Name:MCNIVEN HEARING CENTERS LLC
Entity Type:Organization
Organization Name:MCNIVEN HEARING CENTERS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RAYMON
Authorized Official - Middle Name:DOUGLAS
Authorized Official - Last Name:MCNIVEN
Authorized Official - Suffix:
Authorized Official - Credentials:MA, CCC-A
Authorized Official - Phone:509-993-6348
Mailing Address - Street 1:35 E PROVIDENCE AVE
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99207-1865
Mailing Address - Country:US
Mailing Address - Phone:509-993-6348
Mailing Address - Fax:
Practice Address - Street 1:2309 N DIVISION ST STE 1
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99207-2110
Practice Address - Country:US
Practice Address - Phone:509-993-6348
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-13
Last Update Date:2021-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2005965Medicaid
WA0259611OtherWA LABOR AND INDUSTRIES