Provider Demographics
NPI:1174204564
Name:FOREHAND, JAMES WESLEY (AAS BC-HIS)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:WESLEY
Last Name:FOREHAND
Suffix:
Gender:M
Credentials:AAS BC-HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1518 N BLANDENA ST
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97217-3320
Mailing Address - Country:US
Mailing Address - Phone:702-882-9883
Mailing Address - Fax:
Practice Address - Street 1:1180 NE BURNSIDE RD
Practice Address - Street 2:
Practice Address - City:GRESHAM
Practice Address - State:OR
Practice Address - Zip Code:97030-5711
Practice Address - Country:US
Practice Address - Phone:503-658-9821
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-27
Last Update Date:2023-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORHAS-P-10231923237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist