Healthcare Provider Details

I. General information

NPI: 1205716818
Provider Name (Legal Business Name): WHITNEY KEATON
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/04/2025
Last Update Date: 09/04/2025
Certification Date: 09/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13119 SEATTLE HILL RD
SNOHOMISH WA
98296-3400
US

IV. Provider business mailing address

13119 SEATTLE HILL RD
SNOHOMISH WA
98296-3400
US

V. Phone/Fax

Practice location:
  • Phone: 425-332-3537
  • Fax: 425-391-5692
Mailing address:
  • Phone: 425-332-3537
  • Fax: 425-391-5692

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License NumberHAD0954
License Number StateNM
# 2
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License NumberHIFD.HA.61625945
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: