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General NPI Number Information
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NPI Number | 1972713881
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Entity Type | Organization
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Legal Business Name | AUDIOLOGISTS NORTHWEST
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Dates
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Enumeration Date | 05/23/2007
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Last Update Date | 08/18/2010
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Provider Practice Location Address
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Address Line | 1411 WHEATON WAY
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City | BREMERTON
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State | WA
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Zip | 98310-4427
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Country | US
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Telephone | 360-479-4065
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Fax | 360-479-3820
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Provider Business Mailing Address
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Address Line | 1411 WHEATON WAY
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City | BREMERTON
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State | WA
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Zip | 98310-4427
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Country | US
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Telephone | 360-479-4065
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Fax | 360-479-3820
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Authorized Official
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Title or Position | OWNER
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Name | LYNN E BYRNE
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Credential | MSPA
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Telephone | 360-479-4065
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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 | LD00001002
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License Number State | WA
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