Healthcare Provider Details

I. General information

NPI: 1417330499
Provider Name (Legal Business Name): WYATT C RASMUSSEN AU.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/08/2015
Last Update Date: 03/10/2025
Certification Date: 03/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1220 CENTRAL AVE W
GREAT FALLS MT
59404-3969
US

IV. Provider business mailing address

1220 CENTRAL AVE W
GREAT FALLS MT
59404-3969
US

V. Phone/Fax

Practice location:
  • Phone: 406-727-6577
  • Fax: 406-727-2354
Mailing address:
  • Phone: 406-727-6577
  • Fax: 406-727-2354

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License NumberSLP-AU-LIC-5874
License Number StateMT
# 2
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License NumberSLP-AU-LIC-5874
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: