Provider Demographics
NPI:1255878419
Name:AUDIGY VENTURE GROUP LLC
Entity type:Organization
Organization Name:AUDIGY VENTURE GROUP LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:DRAHN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:360-816-2958
Mailing Address - Street 1:203 SE PARK PLAZA DR
Mailing Address - Street 2:SUITE 270
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98684-5886
Mailing Address - Country:US
Mailing Address - Phone:360-816-2958
Mailing Address - Fax:
Practice Address - Street 1:10330 SE 32ND AVE
Practice Address - Street 2:SUITE 320
Practice Address - City:MILWAUKIE
Practice Address - State:OR
Practice Address - Zip Code:97222-6587
Practice Address - Country:US
Practice Address - Phone:360-816-2958
Practice Address - Fax:360-816-7156
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-26
Last Update Date:2017-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty