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General NPI Number Information
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NPI Number | 1538348719
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Entity Type | Organization
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Legal Business Name | EASTSIDE AUDIOLOGY & HEARING SERVICES PS
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Dates
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Enumeration Date | 10/24/2007
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Last Update Date | 04/11/2013
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Provider Practice Location Address
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Address Line | 49 FRONT ST N
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City | ISSAQUAH
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State | WA
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Zip | 98027-3237
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Country | US
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Telephone | 425-391-3343
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Fax |
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Provider Business Mailing Address
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Address Line | 49 FRONT ST N
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City | ISSAQUAH
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State | WA
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Zip | 98027-3237
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Country | US
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Telephone | 425-391-3343
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/CLINICAL AUDIOLOGIST
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Name | MRS. CHRIS R BORDERS
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Credential | AUD
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Telephone | 425-391-3343
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0700X
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Taxonomy Name | Hearing and Speech Clinic/Center
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License Number | 602423314
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License Number State | WA
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