Provider Demographics
NPI:1326467853
Name:SONOS NEUROTHERAPIES
Entity Type:Organization
Organization Name:SONOS NEUROTHERAPIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KRISTIN
Authorized Official - Middle Name:M
Authorized Official - Last Name:WILLIAMSON
Authorized Official - Suffix:
Authorized Official - Credentials:MS, CCC-SLP
Authorized Official - Phone:541-604-8255
Mailing Address - Street 1:20310 EMPIRE AVE STE A103
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97703-5723
Mailing Address - Country:US
Mailing Address - Phone:541-604-8255
Mailing Address - Fax:541-706-9440
Practice Address - Street 1:20310 EMPIRE AVE STE A103
Practice Address - Street 2:
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97703-5723
Practice Address - Country:US
Practice Address - Phone:541-604-8255
Practice Address - Fax:541-706-9440
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-11
Last Update Date:2022-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR500670437Medicaid