Organization Active NPI

Columbia Regional Program-Audiology

  • Audiologist
  • Portland, OR
National Provider Identifier
1275778235
Registry record updated Dec 4, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
Legal business name
COLUMBIA REGIONAL PROGRAM-AUDIOLOGY
Practice address
833 NE 74TH Ave
Portland, OR 97213-6232
Phone
(503) 916-5570
Fax
(503) 916-2750
NPI assigned
Dec 4, 2008
Last updated
Dec 4, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Jay Genze
Title
Director
Phone
(503) 916-5570

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X NU Primary
Assistive Technology Supplier Audiologist 231HA2500X NU
Audiologist-Hearing Aid Fitter 237600000X NU
Hearing Instrument Specialist 237700000X NU

Addresses

Primary practice location

833 NE 74TH Ave
Portland, OR 97213-6232

Mailing address

833 NE 74TH Ave
Portland, OR 97213-6232
Phone (503) 916-5570

Other identifiers 1

IdentifierTypeStateIssuer
130293MedicaidOR

Other names 1

  • Portland Public School Other name

National Provider Directory

National Provider Directory

Locations

833 NE 74th Ave
Portland, OR 97213
Phone (503) 916-5570

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1228348800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1228348800000",
    "number": "1275778235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "833 NE 74TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972136232",
            "telephone_number": "503-916-5570",
            "fax_number": "503-916-2750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "833 NE 74TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972136232",
            "telephone_number": "503-916-5570",
            "fax_number": "503-916-2750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLUMBIA REGIONAL PROGRAM-AUDIOLOGY",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-12-04",
        "last_updated": "2008-12-04",
        "status": "A",
        "authorized_official_last_name": "GENZE",
        "authorized_official_first_name": "JAY",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "503-916-5570"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "231HA2500X",
            "taxonomy_group": "",
            "desc": "Audiologist, Assistive Technology Supplier",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "237600000X",
            "taxonomy_group": "",
            "desc": "Audiologist-Hearing Aid Fitter",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "237700000X",
            "taxonomy_group": "",
            "desc": "Hearing Instrument Specialist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "130293",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Portland Public School",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Portland, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.