Healthcare Provider Details

I. General information

NPI: 1871279950
Provider Name (Legal Business Name): EMILY RAYE EYLAR AUD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/23/2023
Last Update Date: 07/27/2023
Certification Date: 07/27/2023
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:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License NumberLD61445345
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: