Healthcare Provider Details

I. General information

NPI: 1437390960
Provider Name (Legal Business Name): EVELYN E.M.O DAVIES-VENN MS., AUD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/12/2009
Last Update Date: 03/12/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4033 TALBOT RD SO. #230
RENTON WA
98055
US

IV. Provider business mailing address

4033 TALBOT RD SO. #230
RENTON WA
98055
US

V. Phone/Fax

Practice location:
  • Phone: 425-656-4200
  • Fax: 425-656-4258
Mailing address:
  • Phone: 425-656-4200
  • Fax: 425-656-4258

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License NumberLD60061775
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License NumberLD60061775
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: