Individual
ROBIN MAXON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AU.D
Contact information
Practice address
1613 5TH ST, LA GRANDE, OR 97850-2515
(541) 605-0550
(541) 605-0552
Mailing address
1613 5TH ST, LA GRANDE, OR 97850-2515
(541) 605-0550
(541) 605-0552
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
21908
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
028030000
BLUE CROSS BLUE SHIELD
OR
05
—
158836
—
OR
01
—
640003829
RAILROAD MEDICARE
OR
01
—
I056301
PACIFIC SOURCE
OR
Enumeration date
04/23/2007
Last updated
01/07/2015
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