Individual
MS. CHRISTINE JANE MOULTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S., CCC-A
Contact information
Practice address
1939 E BURNSIDE ST, PORTLAND, OR 97214-1535
(503) 233-6141
(503) 233-2889
Mailing address
1939 E BURNSIDE ST, PORTLAND, OR 97214-1535
(503) 233-6141
(503) 233-2889
Taxonomy
Speciality
Code
Description
License number
State
237600000X
Audiologist-Hearing Aid Fitter
Primary
20586
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0054627
WA WORKERS COMP
WA
05
—
212936
—
OR
01
—
2432417000
FEDERAL WORKERS COMP
—
05
—
9178104
—
WA
Enumeration date
03/06/2007
Last updated
07/09/2007
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