NPIMap

Organization Active NPI

Omak Audiology Center, LLC

  • Audiologist-Hearing Aid Fitter
  • Omak, WA
National Provider Identifier
1659702157
Registry record updated Dec 9, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Audiologist-Hearing Aid FitterTaxonomy code 237600000X
License
LD60323941 Issued in WA
Legal business name
OMAK AUDIOLOGY CENTER, LLC
Practice address
506 Riverside Drive, # B
Omak, WA 98841
Phone
(509) 322-5995
NPI assigned
Dec 9, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2013

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

Authorized official

Name
Dr. Jennie Lynn Mollerup, AU.D.
Title
Owner/Audiologist
Phone
(509) 322-5995

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist-Hearing Aid FitterGroup: 193400000X SINGLE SPECIALTY GROUP 237600000X LD60323941 WA Primary

Addresses

Primary practice location

506 Riverside Drive, # B
Omak, WA 98841

Mailing address

208 S Main St # 29
Omak, WA 98841-9755
Phone (509) 322-5995

Other names 1

  • Omak Audiology Center Doing business as

National Provider Directory

National Provider Directory

Locations

208 S Main St
Ste 29
Omak, WA 98841
Phone (509) 826-7165

208 S Main St
#29
Omak, WA 98841

NPI Registry JSON

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

{
    "created_epoch": "1386547200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1386547200000",
    "number": "1659702157",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "208 S MAIN ST # 29",
            "city": "OMAK",
            "state": "WA",
            "postal_code": "988419755",
            "telephone_number": "509-322-5995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "506 RIVERSIDE DRIVE, # B",
            "city": "OMAK",
            "state": "WA",
            "postal_code": "98841",
            "telephone_number": "509-322-5995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OMAK AUDIOLOGY CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-12-09",
        "last_updated": "2013-12-09",
        "status": "A",
        "authorized_official_last_name": "MOLLERUP",
        "authorized_official_first_name": "JENNIE",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "OWNER/AUDIOLOGIST",
        "authorized_official_telephone_number": "509-322-5995",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "AU.D."
    },
    "taxonomies": [
        {
            "code": "237600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Audiologist-Hearing Aid Fitter",
            "state": "WA",
            "license": "LD60323941",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Omak Audiology Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Omak, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2013; 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.