Provider Demographics
NPI:1982858551
Name:ADVANCED HEARING SERVICES
Entity Type:Organization
Organization Name:ADVANCED HEARING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:LESLIE
Authorized Official - Middle Name:A
Authorized Official - Last Name:EDDY
Authorized Official - Suffix:
Authorized Official - Credentials:BC-HIS
Authorized Official - Phone:503-589-9844
Mailing Address - Street 1:3856 CENTER ST NE
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97301-2905
Mailing Address - Country:US
Mailing Address - Phone:503-589-9844
Mailing Address - Fax:503-589-9850
Practice Address - Street 1:3856 CENTER ST NE
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97301-2905
Practice Address - Country:US
Practice Address - Phone:503-589-9844
Practice Address - Fax:503-589-9850
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-10
Last Update Date:2008-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORHAS-P-175932237700000X
ORHAS-P-10113726237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument SpecialistGroup - Single Specialty