Organization
COLUMBIA REGIONAL PROGRAM-AUDIOLOGY
Active
Other names
Portland Public School
Organization subpart
No
Provider details
NPI number
Authorized official
JAY GENZE (DIRECTOR)
(503) 916-5570
Entity
Organization
Contact information
Practice address
833 NE 74TH AVE, PORTLAND, OR 97213-6232
(503) 916-5570
(503) 916-2750
Mailing address
833 NE 74TH AVE, PORTLAND, OR 97213-6232
(503) 916-5570
(503) 916-2750
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
—
—
231HA2500X
Assistive Technology Supplier Audiologist
—
—
237600000X
Audiologist-Hearing Aid Fitter
—
—
237700000X
Hearing Instrument Specialist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
130293
—
OR
Enumeration date
12/04/2008
Last updated
12/04/2008
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