Organization
WILLOUGHBY HEARING AID CENTERS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTINE MOULTON M.S., CCC-A (AUDIOLOGIST)
(503) 233-6141
Entity
Organization
Contact information
Practice address
1540 9TH AVE SE, ALBANY, OR 97322-4869
(541) 928-2182
(541) 928-2695
Mailing address
1939 E BURNSIDE ST, PORTLAND, OR 97214-1535
(503) 233-6141
(503) 233-2889
Taxonomy
Speciality
Code
Description
License number
State
332S00000X
Hearing Aid Equipment
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
212936
—
OR
01
—
2432417000
FEDERAL WORKERS' COMP
—
Enumeration date
04/02/2007
Last updated
08/22/2020
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