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General NPI Number Information
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NPI Number | 1013934918
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Entity Type | Organization
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Legal Business Name | EVERGREEN SPEECH AND HEARING CLINIC, INC
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Dates
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Enumeration Date | 07/16/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 8301 161ST AVE NE #203
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City | REDMOND
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State | WA
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Zip | 98052-3858
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Country | US
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Telephone | 425-882-4347
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Fax | 425-883-0043
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Provider Business Mailing Address
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Address Line | 8301 161ST AVE NE #203
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City | REDMOND
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State | WA
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Zip | 98052-3858
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Country | US
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Telephone | 425-882-4347
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Fax | 425-883-0043
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Authorized Official
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Title or Position | CLINIC DIRECTOR
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Name | RUTH E NORWOOD
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Credential |
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Telephone | 425-882-4347
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 231H00000X
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Taxonomy Name | Audiologist
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License Number |
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License Number State |
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