Provider Demographics
NPI: | 1770628901 |
---|---|
Name: | NORTHLAND HEARING CENTERS, INC. |
Entity type: | Organization |
Organization Name: | NORTHLAND HEARING CENTERS, INC. |
Other - Org Name: | <UNAVAIL> |
Other - Org Type: | |
Authorized Official - Title/Position: | MANAGER OF THIRD-PARTY PROGRAMS |
Authorized Official - Prefix: | |
Authorized Official - First Name: | KATIE |
Authorized Official - Middle Name: | ANN |
Authorized Official - Last Name: | KLEIN |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 952-999-5299 |
Mailing Address - Street 1: | 6700 WASHINGTON AVE S |
Mailing Address - Street 2: | |
Mailing Address - City: | EDEN PRAIRIE |
Mailing Address - State: | MN |
Mailing Address - Zip Code: | 55344-3405 |
Mailing Address - Country: | US |
Mailing Address - Phone: | |
Mailing Address - Fax: | |
Practice Address - Street 1: | 10909 PORTLAND AVE E |
Practice Address - Street 2: | SUITE T |
Practice Address - City: | TACOMA |
Practice Address - State: | WA |
Practice Address - Zip Code: | 98445-5252 |
Practice Address - Country: | US |
Practice Address - Phone: | 253-476-4300 |
Practice Address - Fax: | 253-537-4900 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2007-02-21 |
Last Update Date: | 2024-05-09 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 237600000X | Speech, Language and Hearing Service Providers | Audiologist-Hearing Aid Fitter | Group - Single Specialty |