Provider Demographics
NPI:1528396918
Name:MERKL, GEORGE GERGELY JR (HAS)
Entity Type:Individual
Prefix:MR
First Name:GEORGE
Middle Name:GERGELY
Last Name:MERKL
Suffix:JR
Gender:M
Credentials:HAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2125 NE 48TH AVE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97213-2065
Mailing Address - Country:US
Mailing Address - Phone:503-287-0055
Mailing Address - Fax:
Practice Address - Street 1:2125 NE 48TH AVE
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97213-2065
Practice Address - Country:US
Practice Address - Phone:503-287-0055
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-11-24
Last Update Date:2009-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORHAS-P-10129544237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist