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General NPI Number Information
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NPI Number | 1528645975
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Entity Type | Organization
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Legal Business Name | FAIRWOOD HEARING CARE, PLLP
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Dates
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Enumeration Date | 03/24/2021
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Last Update Date | 03/24/2021
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Provider Practice Location Address
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Address Line | 16721 SE 162ND ST
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City | RENTON
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State | WA
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Zip | 98058-4229
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Country | US
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Telephone | 206-200-4455
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Fax | 844-791-6253
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Provider Business Mailing Address
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Address Line | 16721 SE 162ND ST
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City | RENTON
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State | WA
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Zip | 98058-4229
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Country | US
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Telephone | 206-200-4455
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Fax | 844-791-6253
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Authorized Official
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Title or Position | AUDIOLOGIST/OWNER
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Name | DAVID ROLLA RENNE
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Credential |
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Telephone | 206-200-4455
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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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