Provider Demographics
NPI:1780927582
Name:NOWICKI, KAREN A (HAD)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:A
Last Name:NOWICKI
Suffix:
Gender:F
Credentials:HAD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8800 SE SUNNYSIDE RD
Mailing Address - Street 2:SUITE 300-N
Mailing Address - City:CLACKAMAS
Mailing Address - State:OR
Mailing Address - Zip Code:97015-5738
Mailing Address - Country:US
Mailing Address - Phone:503-659-5115
Mailing Address - Fax:503-659-5968
Practice Address - Street 1:10404 W COGGINS DR
Practice Address - Street 2:SUITE 110
Practice Address - City:SUN CITY
Practice Address - State:AZ
Practice Address - Zip Code:85351-3437
Practice Address - Country:US
Practice Address - Phone:623-974-9666
Practice Address - Fax:623-974-4813
Is Sole Proprietor?:No
Enumeration Date:2013-03-29
Last Update Date:2013-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZHAD1828237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist