Healthcare Provider Details

I. General information

NPI: 1588089460
Provider Name (Legal Business Name): SOUND ASSOCIATION WESTERN WASHINGTON LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/28/2014
Last Update Date: 04/16/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

108 FACTORY AVE. N. STE 2B
RENTON WA
98057
US

IV. Provider business mailing address

108 FACTORY AVE. N. STE 2B
RENTON WA
98057
US

V. Phone/Fax

Practice location:
  • Phone: 425-251-5477
  • Fax: 425-272-0330
Mailing address:
  • Phone: 425-251-5477
  • Fax: 425-272-0330

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code231H00000X
TaxonomyAudiologist
License NumberLD60410773
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License NumberLD00004217
License Number StateWA

VIII. Authorized Official

Name: DR. PATRICIA JO MUNSON
Title or Position: OWNER
Credential: AUD
Phone: 206-937-8700