Provider Demographics
NPI:1316423064
Name:HEARING CENTER OF VANCOUVER LLC
Entity type:Organization
Organization Name:HEARING CENTER OF VANCOUVER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:DRAHN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:360-816-2958
Mailing Address - Street 1:203 SE PARK PLAZA DR STE 180
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98684-5883
Mailing Address - Country:US
Mailing Address - Phone:360-816-2958
Mailing Address - Fax:360-816-7156
Practice Address - Street 1:16320 SE MILL PLAIN BLVD STE 103
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98684-8918
Practice Address - Country:US
Practice Address - Phone:360-816-2958
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-16
Last Update Date:2018-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty