Provider Demographics
NPI:1366637225
Name:OREGON HEARING SOLUTIONS LLC
Entity Type:Organization
Organization Name:OREGON HEARING SOLUTIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:GAROLD
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:AUD
Authorized Official - Phone:503-625-4111
Mailing Address - Street 1:21323 SW SHERWOOD BLVD
Mailing Address - Street 2:
Mailing Address - City:SHERWOOD
Mailing Address - State:OR
Mailing Address - Zip Code:97140-9218
Mailing Address - Country:US
Mailing Address - Phone:503-625-4111
Mailing Address - Fax:503-625-9879
Practice Address - Street 1:21323 SW SHERWOOD BLVD
Practice Address - Street 2:
Practice Address - City:SHERWOOD
Practice Address - State:OR
Practice Address - Zip Code:97140-9218
Practice Address - Country:US
Practice Address - Phone:503-625-4111
Practice Address - Fax:503-625-9879
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-12
Last Update Date:2007-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR975241332S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332S00000XSuppliersHearing Aid Equipment