Provider Demographics
NPI:1619118957
Name:NORTHLAND HEARING CENTERS INC
Entity Type:Organization
Organization Name:NORTHLAND HEARING CENTERS INC
Other - Org Name:HEARING AID INSTITUTE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:
Authorized Official - Last Name:LONGTAIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:503-257-6800
Mailing Address - Street 1:10570 SE WASHINGTON ST
Mailing Address - Street 2:SUITE 202
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97216
Mailing Address - Country:US
Mailing Address - Phone:503-257-6800
Mailing Address - Fax:
Practice Address - Street 1:705 RESERVE
Practice Address - Street 2:#B
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59801
Practice Address - Country:US
Practice Address - Phone:406-543-5025
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NORTHLAND HEARING CENTERS INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-03-17
Last Update Date:2009-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument SpecialistGroup - Multi-Specialty
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid FitterGroup - Multi-Specialty