Provider Demographics
NPI:1760250294
Name:EKHO AUDIOLOGY LLC
Entity type:Organization
Organization Name:EKHO AUDIOLOGY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUDIOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:KELLY
Authorized Official - Middle Name:MANKIN
Authorized Official - Last Name:ANDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:AUD
Authorized Official - Phone:541-280-7548
Mailing Address - Street 1:780 NW YORK DR STE 102
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97703-1054
Mailing Address - Country:US
Mailing Address - Phone:541-280-7548
Mailing Address - Fax:541-904-8378
Practice Address - Street 1:780 NW YORK DR STE 102
Practice Address - Street 2:
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97703-1054
Practice Address - Country:US
Practice Address - Phone:541-280-7548
Practice Address - Fax:541-904-8378
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-14
Last Update Date:2024-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty
No261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and SpeechGroup - Single Specialty