NPI 1912191909 · live from the CMS NPI Registry
Shelly E Boelter, AuD CCC-A
Audiologist in Portland, OR. National Provider Identifier 1912191909, active.
NPI record
| NPI | 1912191909 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Audiologist 231H00000X |
| Practice location | 3550 Sw Bond Ave, Suite 173, Portland, OR 97239 |
| Practice phone | 503-688-6590 |
| Enumerated | September 1, 2007 |
| Last updated | June 15, 2013 |
| Sole proprietor | Yes |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Audiologist primary | 231H00000X | 22552 (OR) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.