Provider Demographics
NPI:1164730016
Name:HIXSON, JEFF
Entity Type:Individual
Prefix:
First Name:JEFF
Middle Name:
Last Name:HIXSON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10570 SE WASHINGTON ST
Mailing Address - Street 2:SUITE 210
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97216-2846
Mailing Address - Country:US
Mailing Address - Phone:503-257-6800
Mailing Address - Fax:
Practice Address - Street 1:4505 BRAINERD RD
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37411-5429
Practice Address - Country:US
Practice Address - Phone:423-622-1749
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-09-14
Last Update Date:2010-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist