Provider Demographics
NPI:1699091405
Name:SPOKANE HEARING-ORAL PROGRAM OF EXCELLENCE
Entity type:Organization
Organization Name:SPOKANE HEARING-ORAL PROGRAM OF EXCELLENCE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATIVE ASSISTANT
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHYLA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:RODGERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:509-358-7581
Mailing Address - Street 1:310 N. RIVERPOINT BLVD.
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99202-1675
Mailing Address - Country:US
Mailing Address - Phone:509-358-7581
Mailing Address - Fax:509-368-6890
Practice Address - Street 1:310 N. RIVERPOINT BLVD. BOX V
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99202-1675
Practice Address - Country:US
Practice Address - Phone:509-358-7581
Practice Address - Fax:509-368-6890
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-19
Last Update Date:2010-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty