Provider Demographics
NPI:1437361342
Name:IMAGINEARS
Entity Type:Organization
Organization Name:IMAGINEARS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KRISTEN
Authorized Official - Middle Name:A
Authorized Official - Last Name:BECK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:541-776-3461
Mailing Address - Street 1:1875 HIGHWAY 99 N
Mailing Address - Street 2:SUITE 8
Mailing Address - City:ASHLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97520-9120
Mailing Address - Country:US
Mailing Address - Phone:541-488-0628
Mailing Address - Fax:541-552-0628
Practice Address - Street 1:1875 HIGHWAY 99 N
Practice Address - Street 2:SUITE 8
Practice Address - City:ASHLAND
Practice Address - State:OR
Practice Address - Zip Code:97520-9120
Practice Address - Country:US
Practice Address - Phone:541-488-0628
Practice Address - Fax:541-552-0628
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR22174237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid FitterGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR226610Medicaid
ORR132376Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER