Provider Demographics
NPI:1447555842
Name:PALMER, JUDD (BS HAS)
Entity Type:Individual
Prefix:MR
First Name:JUDD
Middle Name:
Last Name:PALMER
Suffix:
Gender:M
Credentials:BS HAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:925 SW 4TH AVE
Mailing Address - Street 2:
Mailing Address - City:CANBY
Mailing Address - State:OR
Mailing Address - Zip Code:97013-3832
Mailing Address - Country:US
Mailing Address - Phone:503-266-9668
Mailing Address - Fax:503-266-9662
Practice Address - Street 1:925 SW 4TH AVE
Practice Address - Street 2:
Practice Address - City:CANBY
Practice Address - State:OR
Practice Address - Zip Code:97013-3832
Practice Address - Country:US
Practice Address - Phone:503-266-9668
Practice Address - Fax:503-266-9662
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-14
Last Update Date:2011-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR10133480237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist