MEDICARE: WYATT C RASMUSSEN AU.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	237600000X	Audiologist-Hearing Aid Fitter	SLP-AU-LIC-5874	MT
2	231H00000X	Audiologist	SLP-AU-LIC-5874	MT

General Provider Information

NPI Number	:	1417330499
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WYATT C RASMUSSEN AU.D.

Provider Business Mailing Address
First Line	:	1220 CENTRAL AVE W
Second Line	:
City	:	GREAT FALLS
State	:	MT
Zip	:	59404-3969
Country	:	US
Telephone Number	:	406-727-6577
Fax Number	:	406-727-2354

Provider Business Practice Location Address
First Line	:	1220 CENTRAL AVE W
Second Line	:
City	:	GREAT FALLS
State	:	MT
Zip	:	59404-3969
Country	:	US
Telephone Number	:	406-727-6577
Fax Number	:	406-727-2354

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/08/2015
Last Update Date	:	03/10/2025

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