Healthcare Provider Details

I. General information

NPI: 1134044696
Provider Name (Legal Business Name): CRYSTAL ORTIZ AUD, CCC-A
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/12/2026
Last Update Date: 08/12/2026
Certification Date: 08/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4800 SAND POINT WAY NE
SEATTLE WA
98105-3901
US

IV. Provider business mailing address

8623 PALATINE AVE N APT 306
SEATTLE WA
98103-3692
US

V. Phone/Fax

Practice location:
  • Phone: 206-987-5173
  • Fax:
Mailing address:
  • Phone: 818-454-9625
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: