Provider Demographics
NPI:1457496226
Name:EUGENE HEARING & SPEECH CENTER
Entity Type:Organization
Organization Name:EUGENE HEARING & SPEECH CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DORIS
Authorized Official - Middle Name:G
Authorized Official - Last Name:TOWERY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:541-485-8521
Mailing Address - Street 1:1500 W 12TH AVE
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97402-3705
Mailing Address - Country:US
Mailing Address - Phone:541-485-8521
Mailing Address - Fax:541-485-6159
Practice Address - Street 1:1500 W 12TH AVE
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97402-3705
Practice Address - Country:US
Practice Address - Phone:541-485-8521
Practice Address - Fax:541-485-6159
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-20
Last Update Date:2012-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR004721Medicaid
OR004721Medicaid
OR386500Medicare Oscar/Certification
ORR0000WCKBQMedicare PIN
OR386500Medicare PIN