Provider Demographics
NPI:1720315492
Name:HARSHAW-IRVIN, SANDRA L (HAD)
Entity Type:Individual
Prefix:
First Name:SANDRA
Middle Name:L
Last Name:HARSHAW-IRVIN
Suffix:
Gender:F
Credentials:HAD
Other - Prefix:
Other - First Name:SANDRA
Other - Middle Name:L
Other - Last Name:HARSHAW
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:HAD
Mailing Address - Street 1:8800 SE SUNNYSIDE ROAD
Mailing Address - Street 2:SUITE 300-N
Mailing Address - City:CLACKAMAS
Mailing Address - State:OR
Mailing Address - Zip Code:97015-5703
Mailing Address - Country:US
Mailing Address - Phone:281-286-2999
Mailing Address - Fax:512-607-4893
Practice Address - Street 1:725 1ST AVENUE NORTH
Practice Address - Street 2:
Practice Address - City:GREAT FALLS
Practice Address - State:MT
Practice Address - Zip Code:59401
Practice Address - Country:US
Practice Address - Phone:406-727-7269
Practice Address - Fax:406-452-5145
Is Sole Proprietor?:No
Enumeration Date:2009-11-17
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT237600000X
MT238237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter