Provider Demographics
NPI:1225588411
Name:ADVANCED HEARING PROVIDERS LLC
Entity Type:Organization
Organization Name:ADVANCED HEARING PROVIDERS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:JOSHUA
Authorized Official - Middle Name:
Authorized Official - Last Name:FRANTZ
Authorized Official - Suffix:
Authorized Official - Credentials:BC-HIS, COHC
Authorized Official - Phone:503-922-2577
Mailing Address - Street 1:18801 SW MARTINAZZI AVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:TUALATIN
Mailing Address - State:OR
Mailing Address - Zip Code:97062-6896
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:18801 SW MARTINAZZI AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:TUALATIN
Practice Address - State:OR
Practice Address - Zip Code:97062-6896
Practice Address - Country:US
Practice Address - Phone:503-922-2577
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-11
Last Update Date:2017-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAHA3996332S00000X
ORHAS-P-10180305332S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332S00000XSuppliersHearing Aid Equipment