Healthcare Provider Details

I. General information

NPI: 1558424804
Provider Name (Legal Business Name): JAMES F WUTH AUD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/18/2006
Last Update Date: 03/28/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

515 MINOR AVE SUITE 150
SEATTLE WA
98104-2120
US

IV. Provider business mailing address

805 MADISON ST SUITE 901
SEATTLE WA
98104-1172
US

V. Phone/Fax

Practice location:
  • Phone: 206-622-9916
  • Fax: 206-682-3012
Mailing address:
  • Phone: 206-264-8100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code231HA2400X
TaxonomyAssistive Technology Practitioner Audiologist
License NumberLD00001031
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License NumberLD00001031
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: