Canizalez, Marshall Albert

Canizalez, Marshall Albert is an individual health care provider with primary practice located at 24076 Se Stark St Ste 230 , Gresham OR 97030-3385. He recently has 2 registered licenses in different health care specialties including Speech, Language and Hearing Service Providers / Audiologist, Speech, Language and Hearing Service Providers / Audiologist-Hearing Aid Fitter. Speech, Language and Hearing Service Providers / Audiologist is his primary health care specialty. Canizalez, Marshall Albert can be contacted via phone (503) 488-2600.

Contact Information

Primary practice address
24076 Se Stark St Ste 230 Gresham OR 97030-3385
Phone: (503) 488-2600
Fax: (503) 465-5468
Website:
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Health care specialties

SpecialtyCodeLicense #State
Speech, Language and Hearing Service Providers / Audiologist 231H00000X 147001852 Illinois
Speech, Language and Hearing Service Providers / Audiologist-Hearing Aid Fitter 237600000X
Speech, Language and Hearing Service Providers / Audiologist 231H00000X 31054 Oregon

Profile Details

NPI number 1376205278
LBN Legal business name Canizalez, Marshall Albert
Credentials AU.D
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 7th, 2021
Last updated Dec 29th, 2022 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1376205278 NPPES
Oregon MEDICAID 500813168

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