Provider Demographics
NPI:1639107956
Name:O'LOUGHLIN, DENNIS (AUD)
Entity Type:Individual
Prefix:DR
First Name:DENNIS
Middle Name:
Last Name:O'LOUGHLIN
Suffix:
Gender:M
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3857 WOLVERINE ST NE
Mailing Address - Street 2:BUILDING C, SUITE 16
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97305-4270
Mailing Address - Country:US
Mailing Address - Phone:503-588-1039
Mailing Address - Fax:
Practice Address - Street 1:3857 WOLVERINE ST NE
Practice Address - Street 2:BUILDING C, SUITE 16
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97305-4270
Practice Address - Country:US
Practice Address - Phone:503-588-1039
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2010-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR22387231H00000X
ORHAS-P-051619237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR134250Medicare ID - Type Unspecified