Provider Demographics
NPI:1831649334
Name:OREGON HEARING HEALTH SERVICE, LLC
Entity Type:Organization
Organization Name:OREGON HEARING HEALTH SERVICE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SAMUEL
Authorized Official - Middle Name:AARON
Authorized Official - Last Name:MATHENY
Authorized Official - Suffix:
Authorized Official - Credentials:HAS-P
Authorized Official - Phone:541-258-6166
Mailing Address - Street 1:90 MARKET ST STE 70
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:OR
Mailing Address - Zip Code:97355-2395
Mailing Address - Country:US
Mailing Address - Phone:541-258-6166
Mailing Address - Fax:541-258-6166
Practice Address - Street 1:90 MARKET ST STE 70
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:OR
Practice Address - Zip Code:97355-2395
Practice Address - Country:US
Practice Address - Phone:541-258-6166
Practice Address - Fax:541-258-6166
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-07
Last Update Date:2020-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORHAS-P-165880332S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332S00000XSuppliersHearing Aid Equipment