Provider Demographics
NPI:1013162874
Name:SIEBERS, ROBERT A (BC-HIS)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:A
Last Name:SIEBERS
Suffix:
Gender:M
Credentials:BC-HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10395 NW GLENCOE RD STE 500
Mailing Address - Street 2:
Mailing Address - City:NORTH PLAINS
Mailing Address - State:OR
Mailing Address - Zip Code:97133-8223
Mailing Address - Country:US
Mailing Address - Phone:503-647-2095
Mailing Address - Fax:503-647-2096
Practice Address - Street 1:10395 NW GLENCOE RD STE 500
Practice Address - Street 2:
Practice Address - City:NORTH PLAINS
Practice Address - State:OR
Practice Address - Zip Code:97133-8223
Practice Address - Country:US
Practice Address - Phone:503-647-2095
Practice Address - Fax:503-647-2096
Is Sole Proprietor?:No
Enumeration Date:2008-11-20
Last Update Date:2014-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORHAS-P-225591237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist