Individual
MARSHALL ALBERT CANIZALEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
AU.D
Contact information
Practice address
24076 SE STARK ST STE 230, GRESHAM, OR 97030-3385
(503) 488-2600
(503) 465-5468
Mailing address
847 NE 19TH AVE STE 300, PORTLAND, OR 97232-2686
(503) 963-2801
(503) 963-2825
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
147001852
IL
231H00000X
Audiologist
Primary
31054
OR
237600000X
Audiologist-Hearing Aid Fitter
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500813168
—
OR
Enumeration date
10/07/2021
Last updated
12/29/2022
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