Active NPI
Christine Jane Moulton, M.S., CCC-A
- Audiologist-Hearing Aid Fitter
- Portland, OR
National Provider Identifier
1720118151
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Audiologist-Hearing Aid Fitter
- License
- 20586
- Practice address
- 1939 E Burnside St
Portland, OR 97214-1535 - Phone
- (503) 233-6141
- Fax
- (503) 233-2889
- NPI assigned
- Mar 6, 2007
- 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-Hearing Aid Fitter | 237600000X | 20586 | OR | Primary |
Addresses
Primary practice location
1939 E Burnside St
Portland, OR 97214-1535
Mailing address
1939 E Burnside St
Portland, OR 97214-1535
Phone (503) 233-6141
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 212936 | Medicaid | OR | |
| 2432417000 | Other | FEDERAL WORKERS COMP | |
| 9178104 | Medicaid | WA | |
| 0054627 | Other | WA | WA WORKERS COMP |
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
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20586 | OR | MD | Audiologist-Hearing Aid Fitter |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173139200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1720118151",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1939 E BURNSIDE ST",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972141535",
"telephone_number": "503-233-6141",
"fax_number": "503-233-2889"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1939 E BURNSIDE ST",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972141535",
"telephone_number": "503-233-6141",
"fax_number": "503-233-2889"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOULTON",
"first_name": "CHRISTINE",
"middle_name": "JANE",
"name_prefix": "Ms.",
"credential": "M.S., CCC-A",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-06",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "237600000X",
"taxonomy_group": "",
"desc": "Audiologist-Hearing Aid Fitter",
"state": "OR",
"license": "20586",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "212936",
"state": "OR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FEDERAL WORKERS COMP",
"identifier": "2432417000",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "9178104",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WA WORKERS COMP",
"identifier": "0054627",
"state": "WA"
}
],
"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 Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.