Basic Information
| Provider Information | |||||||||
| NPI: | 1730488693 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | CASCADE AUDIOLOGY AND HEARING AID CENTER PLLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 111 S 13TH ST | ||||||||
| Address2: | |||||||||
| City: | MOUNT VERNON | ||||||||
| State: | WA | ||||||||
| PostalCode: | 982744105 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3603362178 | ||||||||
| FaxNumber: | 3603361995 | ||||||||
| Practice Location | |||||||||
| Address1: | 118 S 12TH ST | ||||||||
| Address2: | |||||||||
| City: | MOUNT VERNON | ||||||||
| State: | WA | ||||||||
| PostalCode: | 982744036 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3603362178 | ||||||||
| FaxNumber: | 3603361995 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/17/2011 | ||||||||
| LastUpdateDate: | 03/17/2011 | ||||||||
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| AuthorizedOfficialLastName: | HANNAH | ||||||||
| AuthorizedOfficialFirstName: | SHONIE | ||||||||
| AuthorizedOfficialMiddleName: | E | ||||||||
| AuthorizedOfficialTitleorPosition: | HEAD AUDIOLOGIST | ||||||||
| AuthorizedOfficialTelephone: | 3603362178 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QH0700X | 603052627 | WA | Y | Ambulatory Health Care Facilities | Clinic/Center | Hearing and Speech |
No ID Information.