Basic Information
| Provider Information | |||||||||
| NPI: | 1023239829 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SAFADY | ||||||||
| FirstName: | STACI | ||||||||
| MiddleName: | H. | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | AU.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8800 SE SUNNYSIDE RD STE 300N | ||||||||
| Address2: | |||||||||
| City: | CLACKAMAS | ||||||||
| State: | OR | ||||||||
| PostalCode: | 970155703 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2812862999 | ||||||||
| FaxNumber: | 5126074893 | ||||||||
| Practice Location | |||||||||
| Address1: | 295 BUCK RD STE 107 | ||||||||
| Address2: | |||||||||
| City: | HOLLAND | ||||||||
| State: | PA | ||||||||
| PostalCode: | 189661748 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2153105915 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/01/2007 | ||||||||
| LastUpdateDate: | 03/17/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 231H00000X | AT-000933L | PA | N | Speech, Language and Hearing Service Providers | Audiologist | 231H00000X | YA 00496 | NJ | N | Speech, Language and Hearing Service Providers | Audiologist | 237600000X | MG 00925 | NJ | N | Speech, Language and Hearing Service Providers | Audiologist-Hearing Aid Fitter | 237700000X | PA | N | Speech, Language and Hearing Service Providers | Hearing Instrument Specialist | 237600000X | PA | Y | Speech, Language and Hearing Service Providers | Audiologist-Hearing Aid Fitter |
No ID Information.