Healthcare Provider Details

I. General information

NPI: 1043536345
Provider Name (Legal Business Name): UW SPEECH & HEARING CLINIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/12/2010
Last Update Date: 04/12/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4131 15TH AVE. NE
SEATTLE WA
98105-6299
US

IV. Provider business mailing address

4131 15TH AVE. NE
SEATTLE WA
98105-6299
US

V. Phone/Fax

Practice location:
  • Phone: 206-543-5440
  • Fax: 206-616-1185
Mailing address:
  • Phone: 206-543-5440
  • Fax: 206-616-1185

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code231HA2500X
TaxonomyAssistive Technology Supplier Audiologist
License NumberLD00002371
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License NumberLD00002371
License Number StateWA
# 3
Primary TaxonomyN
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License NumberLD00002371
License Number StateWA
# 4
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License NumberLD00002371
License Number StateWA

VIII. Authorized Official

Name: MRS. NANCY B. ALARCON
Title or Position: CLINIC DIRECTOR
Credential: M.S., CCC-SLP
Phone: 206-685-2212