Healthcare Provider Details

I. General information

NPI: 1871285460
Provider Name (Legal Business Name): ANNA N TVEITE AUD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ANNA N SELCHOW AUD

II. Dates (important events)

Enumeration Date: 05/23/2023
Last Update Date: 12/28/2023
Certification Date: 12/28/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

211 S 13TH ST
MOUNT VERNON WA
98274-4107
US

IV. Provider business mailing address

1400 E KINCAID ST
MOUNT VERNON WA
98274-4127
US

V. Phone/Fax

Practice location:
  • Phone: 360-336-2178
  • Fax: 360-336-1995
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License NumberLD61453852
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: