Healthcare Provider Details
I. General information
NPI: 1396780995
Provider Name (Legal Business Name): ASHLEY CARLOTTA AL-IZZI AUD
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 06/18/2006
Last Update Date: 10/03/2025
Certification Date: 10/03/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
12911 120TH AVE NE STE E40
KIRKLAND WA
98034-3045
US
IV. Provider business mailing address
12911 120TH AVE NE STE E40
KIRKLAND WA
98034-3045
US
V. Phone/Fax
- Phone: 425-821-6600
- Fax:
- Phone: 425-821-6600
- Fax: 425-821-6602
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 231H00000X |
| Taxonomy | Audiologist |
| License Number | LD00004507 |
| License Number State | WA |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 237600000X |
| Taxonomy | Audiologist-Hearing Aid Fitter |
| License Number | LD00004507 |
| License Number State | WA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: