Provider Demographics
NPI:1447632328
Name:EAR, NOSE AND THROAT ASSOCIATES, LLC.
Entity type:Organization
Organization Name:EAR, NOSE AND THROAT ASSOCIATES, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATIVE MANAGER/PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JON
Authorized Official - Middle Name:KIMBERLAY
Authorized Official - Last Name:THIRINGER
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:503-648-8971
Mailing Address - Street 1:900 SE OAK ST STE 201
Mailing Address - Street 2:
Mailing Address - City:HILLSBORO
Mailing Address - State:OR
Mailing Address - Zip Code:97123-4287
Mailing Address - Country:US
Mailing Address - Phone:503-648-8971
Mailing Address - Fax:503-640-6461
Practice Address - Street 1:900 SE OAK ST STE 201
Practice Address - Street 2:
Practice Address - City:HILLSBORO
Practice Address - State:OR
Practice Address - Zip Code:97123-4287
Practice Address - Country:US
Practice Address - Phone:503-648-8971
Practice Address - Fax:503-640-6461
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-26
Last Update Date:2022-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207YX0007XAllopathic & Osteopathic PhysiciansOtolaryngologyPlastic Surgery within the Head & NeckGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR287225Medicaid
OR116033Medicaid
OR1265515761OtherNPI
OR500645716Medicaid
OR071642Medicaid
OR1699753822OtherNPI
OR1396845756OtherNPI
OR1477656767OtherNPI
OR287225Medicaid
OR500645716Medicaid
OR116033Medicaid
ORR135931Medicare PIN