Healthcare Provider Details

I. General information

NPI: 1780245076
Provider Name (Legal Business Name): DIANE HOFSTETTER-TAYLOR HEARING AID SPECIALI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/26/2019
Last Update Date: 06/26/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8317 E MILL PLAIN BLVD
VANCOUVER WA
98664-2006
US

IV. Provider business mailing address

8317 E MILL PLAIN BLVD
VANCOUVER WA
98664-2006
US

V. Phone/Fax

Practice location:
  • Phone: 360-690-4327
  • Fax: 360-690-4327
Mailing address:
  • Phone: 360-690-4327
  • Fax: 360-690-4327

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License NumberHA00004638
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: