Healthcare Provider Details

I. General information

NPI: 1225766298
Provider Name (Legal Business Name): SHELBY LYNN HOLST AU.D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/09/2022
Last Update Date: 10/09/2025
Certification Date: 10/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16259 SYLVESTER RD SW STE 504
BURIEN WA
98166-3059
US

IV. Provider business mailing address

16259 SYLVESTER RD SW STE 501
BURIEN WA
98166-3059
US

V. Phone/Fax

Practice location:
  • Phone: 206-242-3696
  • Fax: 206-246-1078
Mailing address:
  • Phone: 206-242-3696
  • Fax: 206-246-1078

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License NumberAUD.LD.61344865
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code231HA2400X
TaxonomyAssistive Technology Practitioner Audiologist
License NumberLD61344865
License Number StateWA
# 3
Primary TaxonomyN
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License NumberLD61344865
License Number StateWA
# 4
Primary TaxonomyN
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License NumberLD61344865
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: