Healthcare Provider Details
I. General information
NPI: 1073789988
Provider Name (Legal Business Name): SOUND ASSOCIATES WESTERN WASHINGTON LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/01/2008
Last Update Date: 05/01/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
9776 HOLMAN RD NW SUITE 101
SEATTLE WA
98117
US
IV. Provider business mailing address
9776 HOLMAN RD NW SUITE 101
SEATTLE WA
98117
US
V. Phone/Fax
- Phone: 206-782-6770
- Fax: 206-957-6003
- Phone: 206-782-6770
- Fax: 206-957-6003
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 237700000X |
| Taxonomy | Hearing Instrument Specialist |
| License Number | HA00000409 |
| License Number State | WA |
VIII. Authorized Official
Name: MR.
SHAWN
P
UTIGARD
Title or Position: OWNER MEMBER
Credential: HIS
Phone: 206-782-6770