Healthcare Provider Details

I. General information

NPI: 1861346272
Provider Name (Legal Business Name): SEASHELL AUDIOLOGY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/23/2026
Last Update Date: 03/27/2026
Certification Date: 03/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

733 E GARFIELD ST APT 10
PHOENIX AZ
85006-3278
US

IV. Provider business mailing address

PO BOX 27461
TEMPE AZ
85285-7461
US

V. Phone/Fax

Practice location:
  • Phone: 602-690-9669
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number
License Number State

VIII. Authorized Official

Name: SADAF FATEH
Title or Position: OWNER
Credential: AU.D
Phone: 602-690-9669