Healthcare Provider Details

I. General information

NPI: 1356580310
Provider Name (Legal Business Name): AMERICAN ADVANCED HEARING AID LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/16/2009
Last Update Date: 09/08/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

121 SE EVERETT MALL WAY SUITE B
EVERETT WA
98208
US

IV. Provider business mailing address

121 SE EVERETT MALL WAY SUITE B
EVERETT WA
98208
US

V. Phone/Fax

Practice location:
  • Phone: 425-265-1100
  • Fax: 425-265-1199
Mailing address:
  • Phone: 425-265-1100
  • Fax: 425-265-1199

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332S00000X
TaxonomyHearing Aid Equipment
License Number60259511900
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License NumberHA00002879
License Number StateWA
# 3
Primary TaxonomyY
Taxonomy Code332S00000X
TaxonomyHearing Aid Equipment
License Number602595119
License Number StateWA

VIII. Authorized Official

Name: JAMAL M DASHTI
Title or Position: OWNER
Credential: H.I.S.
Phone: 425-265-1100