Provider Demographics
NPI:1598235608
Name:GRIFFIN CENTER
Entity Type:Organization
Organization Name:GRIFFIN CENTER
Other - Org Name:SOUND START
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:KIM
Authorized Official - Middle Name:
Authorized Official - Last Name:ATWILL
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:503-567-2231
Mailing Address - Street 1:9955 SW BEAVERTON HILLSDALE HWY STE 115
Mailing Address - Street 2:
Mailing Address - City:BEAVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97005-3228
Mailing Address - Country:US
Mailing Address - Phone:503-567-2231
Mailing Address - Fax:888-895-4828
Practice Address - Street 1:9955 SW BEAVERTON HILLSDALE HWY STE 115
Practice Address - Street 2:
Practice Address - City:BEAVERTON
Practice Address - State:OR
Practice Address - Zip Code:97005-3228
Practice Address - Country:US
Practice Address - Phone:602-363-0622
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-30
Last Update Date:2020-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech
No252Y00000XAgenciesEarly Intervention Provider Agency
No332S00000XSuppliersHearing Aid Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR500761450Medicaid