Provider Demographics
NPI:1710157276
Name:OREGON HEARING AND SPEECH CENTER
Entity Type:Organization
Organization Name:OREGON HEARING AND SPEECH CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:DILLOW
Authorized Official - Suffix:
Authorized Official - Credentials:BA
Authorized Official - Phone:503-492-8000
Mailing Address - Street 1:735 SE MOUNT HOOD HWY
Mailing Address - Street 2:PO BOX 623
Mailing Address - City:GRESHAM
Mailing Address - State:OR
Mailing Address - Zip Code:97080-9280
Mailing Address - Country:US
Mailing Address - Phone:503-492-8000
Mailing Address - Fax:503-492-8444
Practice Address - Street 1:735 SE MOUNT HOOD HWY
Practice Address - Street 2:
Practice Address - City:GRESHAM
Practice Address - State:OR
Practice Address - Zip Code:97080-9280
Practice Address - Country:US
Practice Address - Phone:503-492-8000
Practice Address - Fax:503-492-8444
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-11
Last Update Date:2008-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid FitterGroup - Multi-Specialty
No237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument SpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR028074Medicaid
OR028074Medicaid