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General NPI Number Information
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NPI Number | 1326869298
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Entity Type | Organization
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Legal Business Name | GOLD STAR AUDIOLOGY CLINIC
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Dates
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Enumeration Date | 10/22/2024
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Last Update Date | 10/22/2024
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Provider Practice Location Address
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Address Line | 209 MASON RUNN LN
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City | RISING SUN
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State | MD
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Zip | 21911-1699
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Country | US
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Telephone | 360-892-3445
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Fax | 360-213-2044
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Provider Business Mailing Address
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Address Line | 16209 SE MCGILLIVRAY BLVD STE M
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City | VANCOUVER
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State | WA
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Zip | 98683-9034
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Country | US
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Telephone | 360-892-3445
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Fax | 360-213-2044
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Authorized Official
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Title or Position | OWNER
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Name | DR. CHRISTOPHER EUGENE LAWSON
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Credential | AUD
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Telephone | 360-892-3445
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332S00000X
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Taxonomy Name | Hearing Aid Equipment
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QH0700X
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Taxonomy Name | Hearing and Speech Clinic/Center
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License Number |
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License Number State |
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