Provider Demographics
NPI:1972769636
Name:HURLEY, MICHELE (MS)
Entity type:Individual
Prefix:
First Name:MICHELE
Middle Name:
Last Name:HURLEY
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10570 SE WASHINGTON ST
Mailing Address - Street 2:STE. 202
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97216-2846
Mailing Address - Country:US
Mailing Address - Phone:214-557-6727
Mailing Address - Fax:214-324-1301
Practice Address - Street 1:10565 VINEMONT ST
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75218-2353
Practice Address - Country:US
Practice Address - Phone:214-557-6727
Practice Address - Fax:214-324-1301
Is Sole Proprietor?:No
Enumeration Date:2008-08-01
Last Update Date:2009-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX50708237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter