NPIMap

Organization Active NPI

Ear, Nose, Throat & Allergy Assoicaties PS

  • Audiologist
  • Puyallup, WA
National Provider Identifier
1104149210
Registry record updated Mar 3, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
LD60130143 Issued in WA
Legal business name
EAR, NOSE, THROAT & ALLERGY ASSOICATIES PS
Practice address
104 27TH Ave SE
Puyallup, WA 98374-1145
Phone
(253) 770-8454
Fax
(253) 770-8992
NPI assigned
Mar 3, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Randall Bennett, M.D.
Title
Owner
Phone
(253) 770-8454

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
AudiologistGroup: 193400000X SINGLE SPECIALTY GROUP 231H00000X LD60130143 WA Primary

Addresses

Primary practice location

104 27TH Ave SE
Puyallup, WA 98374-1145

Mailing address

104 27TH Ave SE
Puyallup, WA 98374-1145
Phone (253) 770-8454

National Provider Directory

National Provider Directory
Tax ID family
Ear Nose Throat Allergy Assoicaties PS2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1267574400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1267574400000",
    "number": "1104149210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 27TH AVE SE",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983741145",
            "telephone_number": "253-770-8454",
            "fax_number": "253-770-8992"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 27TH AVE SE",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983741145",
            "telephone_number": "253-770-8454",
            "fax_number": "253-770-8992"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAR, NOSE, THROAT & ALLERGY ASSOICATIES PS",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-03",
        "last_updated": "2010-03-03",
        "status": "A",
        "authorized_official_last_name": "BENNETT",
        "authorized_official_first_name": "RANDALL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "253-770-8454",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Audiologist",
            "state": "WA",
            "license": "LD60130143",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Puyallup, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.