Healthcare Provider Details

I. General information

NPI: 1598192726
Provider Name (Legal Business Name): JONATHAN MATTHEW ZIEGLER AUD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/02/2013
Last Update Date: 10/14/2022
Certification Date: 10/14/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

217 W CATALDO AVE FL 2
SPOKANE WA
99201-2217
US

IV. Provider business mailing address

PO BOX 421
LIBERTY LAKE WA
99019-0421
US

V. Phone/Fax

Practice location:
  • Phone: 509-624-2326
  • Fax: 509-252-2837
Mailing address:
  • Phone: 866-747-2455
  • Fax: 509-227-7070

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License NumberLD60405604
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code231HA2400X
TaxonomyAssistive Technology Practitioner Audiologist
License NumberLD60405604
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: