Active NPI
Diana Fitzgerald, AU.D.
- Audiologist
- Walla Walla, WA
National Provider Identifier
1093190886
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Audiologist
- License
- LD60576834
- Practice address
- 55 W Tietan St
Walla Walla, WA 99362-4445 - Phone
- (509) 525-3720
- NPI assigned
- Jul 22, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Audiologist | 231H00000X | LD60576834 | WA | Primary |
Addresses
Primary practice location
55 W Tietan St
Walla Walla, WA 99362-4445
Mailing address
55 W Tietan St
Walla Walla, WA 99362-4445
Phone (509) 525-3720
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LD60576834 | WA | MD | Audiologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1437523200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1437523200000",
"number": "1093190886",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "55 W TIETAN ST",
"city": "WALLA WALLA",
"state": "WA",
"postal_code": "993624445",
"telephone_number": "509-525-3720"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "55 W TIETAN ST",
"city": "WALLA WALLA",
"state": "WA",
"postal_code": "993624445",
"telephone_number": "509-525-3720"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FITZGERALD",
"first_name": "DIANA",
"credential": "AU.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-07-22",
"last_updated": "2015-07-22",
"status": "A"
},
"taxonomies": [
{
"code": "231H00000X",
"taxonomy_group": "",
"desc": "Audiologist",
"state": "WA",
"license": "LD60576834",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Walla Walla, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.