Healthcare Provider Details

I. General information

NPI: 1366996589
Provider Name (Legal Business Name): CASCADE HEARING AID CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/04/2016
Last Update Date: 08/04/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

249 E MAIN ST # 151
MONROE WA
98272-1507
US

IV. Provider business mailing address

249 E MAIN ST # 151
MONROE WA
98272-1507
US

V. Phone/Fax

Practice location:
  • Phone: 360-805-5700
  • Fax: 360-805-5701
Mailing address:
  • Phone: 360-805-5700
  • Fax: 360-805-5701

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332S00000X
TaxonomyHearing Aid Equipment
License NumberHA 00002344
License Number StateWA

VIII. Authorized Official

Name: RANDALL ZAVALES
Title or Position: OWNER
Credential:
Phone: 360-805-5700