Healthcare Provider Details

I. General information

NPI: 1164904959
Provider Name (Legal Business Name): HEALTH SERVICES SEATTLE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/29/2018
Last Update Date: 12/05/2024
Certification Date: 12/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1059 E IRON EAGLE DR STE 175
EAGLE ID
83616-6855
US

IV. Provider business mailing address

10557 W CARLTON BAY DRIVE SUITE 201
GARDEN CITY ID
83714-0001
US

V. Phone/Fax

Practice location:
  • Phone: 208-957-6418
  • Fax: 208-912-0448
Mailing address:
  • Phone: 208-310-7127
  • Fax: 208-912-0448

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License Number
License Number State

VIII. Authorized Official

Name: MELISSA ALLSOPP
Title or Position: INSURANCE AND BILLING SPECIALIST
Credential:
Phone: 208-310-7127