Healthcare Provider Details

I. General information

NPI: 1982909586
Provider Name (Legal Business Name): VOCAL LABS OUTLET STORES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/13/2011
Last Update Date: 01/13/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

104 39TH AVE SW SUITE B
PUYALLUP WA
98373-3621
US

IV. Provider business mailing address

104 39TH AVE SW SUITE B
PUYALLUP WA
98373-3621
US

V. Phone/Fax

Practice location:
  • Phone: 253-604-4562
  • Fax: 253-604-4563
Mailing address:
  • Phone: 253-604-4562
  • Fax: 253-604-4563

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number609
License Number StateWA

VIII. Authorized Official

Name: JAMES PANNETTE
Title or Position: REGIONAL DIRECTOR
Credential:
Phone: 253-604-4562