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General NPI Number Information
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NPI Number | 1114189743
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Entity Type | Organization
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Legal Business Name | PUGET SOUND HEARING AND BALANCE
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Dates
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Enumeration Date | 06/25/2008
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Last Update Date | 06/25/2008
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Provider Practice Location Address
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Address Line | 9714 3RD AVE NE SUITE 100
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City | SEATTLE
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State | USA
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Zip | 98115
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Country | UM
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Telephone | 206-523-5584
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Fax | 206-523-5882
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Provider Business Mailing Address
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Address Line | PO BOX 59325
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City | RENTON
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State | WA
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Zip | 98058-2325
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Country | US
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Telephone | 425-204-6958
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Fax | 206-523-5882
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Authorized Official
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Title or Position | BILLER
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Name | SANDY ARTHALONY
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Credential |
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Telephone | 425-204-6958
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | MD27287
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License Number State | WA
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