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Organization

PHOENIX HEARING

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. BARRY A JETER NBC/HIS (SPECIALIST/ MANAGER)
(360) 433-8136
Entity
Organization

Contact information

Practice address
2402 BROADWAY ST, VANCOUVER, WA 98663-3229
(360) 433-8136
(360) 567-0620
Mailing address
6400 NE HIGHWAY 99, #G167, VANCOUVER, WA 98665-8748
(360) 433-8136
(360) 567-0620

Taxonomy

Speciality
Code
Description
License number
State
237700000X
Hearing Instrument Specialist
Primary
HA3375
WA

Other

Enumeration date
04/15/2011
Last updated
04/15/2011
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