Provider Demographics
NPI:1376696047
Name:NOON, DUANE LEE (HAS)
Entity Type:Individual
Prefix:MR
First Name:DUANE
Middle Name:LEE
Last Name:NOON
Suffix:
Gender:M
Credentials:HAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:820 E MAIN ST
Mailing Address - Street 2:#B
Mailing Address - City:MEDFORD
Mailing Address - State:OR
Mailing Address - Zip Code:97504-7121
Mailing Address - Country:US
Mailing Address - Phone:541-773-7409
Mailing Address - Fax:541-779-0612
Practice Address - Street 1:820 E MAIN ST
Practice Address - Street 2:#B
Practice Address - City:MEDFORD
Practice Address - State:OR
Practice Address - Zip Code:97504-7121
Practice Address - Country:US
Practice Address - Phone:541-773-7409
Practice Address - Fax:541-779-0612
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORHAS-P-83151237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR121434Medicaid