Active NPI
Laura G. Polich, PH.D., CCC-A & SLP
- Audiologist
- Portland, OR
National Provider Identifier
1447357801
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Audiologist
- License
- 22898
- Practice address
- 825 NE 20TH Ave
Suite 230
Portland, OR 97232-2275 - Phone
- (503) 806-1498
- Fax
- (503) 805-5244
- NPI assigned
- Sep 20, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Audiologist | 231H00000X | 22898 | OR | Primary |
| Audiologist | 231H00000X | LD00004694 | WA |
Addresses
Primary practice location
825 NE 20TH Ave
Suite 230
Portland, OR 97232-2275
Mailing address
825 NE 20TH Ave
Suite 230
Portland, OR 97232-2275
Phone (503) 806-1498
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 22898 | OR | MD | Audiologist |
| LD00004694 | WA | MD | Audiologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158710400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1222041600000",
"number": "1447357801",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "825 NE 20TH AVE",
"address_2": "SUITE 230",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972322275",
"telephone_number": "503-806-1498",
"fax_number": "503-805-5244"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "825 NE 20TH AVE",
"address_2": "SUITE 230",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972322275",
"telephone_number": "503-806-1498",
"fax_number": "503-805-5244"
}
],
"practiceLocations": [],
"basic": {
"last_name": "POLICH",
"first_name": "LAURA",
"middle_name": "G.",
"name_prefix": "Dr.",
"credential": "PH.D., CCC-A & SLP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-09-20",
"last_updated": "2008-09-22",
"status": "A"
},
"taxonomies": [
{
"code": "231H00000X",
"taxonomy_group": "",
"desc": "Audiologist",
"state": "OR",
"license": "22898",
"primary": true
},
{
"code": "231H00000X",
"taxonomy_group": "",
"desc": "Audiologist",
"state": "WA",
"license": "LD00004694",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}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 Sep 22, 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.