Healthcare Provider Details

I. General information

NPI: 1417436668
Provider Name (Legal Business Name): STEPHANIE MICHELLE SCOTT AUD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/08/2018
Last Update Date: 09/20/2024
Certification Date: 09/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 LILLY RD NE
OLYMPIA WA
98506-5115
US

IV. Provider business mailing address

700 LILLY RD NE
OLYMPIA WA
98506-5115
US

V. Phone/Fax

Practice location:
  • Phone: 360-923-7000
  • Fax: 360-923-7089
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License NumberLD60880935
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: