Active NPI
Heather Marie Larson, AU.D.
- Audiologist
- Newberg, OR
National Provider Identifier
1669645842
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Audiologist
- License
- 22930
- Practice address
- 310 Villa Rd
Suite 104
Newberg, OR 97132-1886 - Phone
- (503) 537-3546
- NPI assigned
- Apr 8, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Audiologist | 231H00000X | 22930 | OR | Primary |
Addresses
Primary practice location
310 Villa Rd
Suite 104
Newberg, OR 97132-1886
Mailing address
435 NW Island Cir
Apt. B1
Beaverton, OR 97006-8362
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 22930 | OR | MD | Audiologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1207612800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1207612800000",
"number": "1669645842",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "435 NW ISLAND CIR",
"address_2": "APT. B1",
"city": "BEAVERTON",
"state": "OR",
"postal_code": "970068362"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "310 VILLA RD",
"address_2": "SUITE 104",
"city": "NEWBERG",
"state": "OR",
"postal_code": "971321886",
"telephone_number": "503-537-3546"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LARSON",
"first_name": "HEATHER",
"middle_name": "MARIE",
"name_prefix": "Dr.",
"credential": "AU.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-04-08",
"last_updated": "2008-04-08",
"status": "A"
},
"taxonomies": [
{
"code": "231H00000X",
"taxonomy_group": "",
"desc": "Audiologist",
"state": "OR",
"license": "22930",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Newberg, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 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.