NPIMap

Organization Active NPI

Providence Audiology

  • Specialist
  • Seattle, WA
National Provider Identifier
1790801801
Registry record updated Oct 25, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
LD00001067 Issued in WA
Legal business name
PROVIDENCE AUDIOLOGY
Practice address
1600 E Jefferson St
Suite 202
Seattle, WA 98122-5698
Phone
(206) 320-5687
Fax
(206) 320-8145
NPI assigned
Mar 21, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2010

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

Authorized official

Name
Sandra Ellis, AU.D., FAAANPI 1962413096
Title
Owner
Phone
(206) 320-5687

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X LD00001067 WA Primary

Addresses

Primary practice location

1600 E Jefferson St
Suite 202
Seattle, WA 98122-5698

Mailing address

1600 E Jefferson St
Suite 202
Seattle, WA 98122-5698
Phone (206) 320-5687

Other names 1

  • Seattle Hearing and Balance Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040227000797 WA Part B Supplier - Clinic/Group Practice 0547156234 Receives reassigned benefits from 3 practitioners
Practice locations: Seattle, WA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1174435200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1287964800000",
    "number": "1790801801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 E JEFFERSON ST",
            "address_2": "SUITE 202",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981225698",
            "telephone_number": "206-320-5687",
            "fax_number": "206-320-8145"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 E JEFFERSON ST",
            "address_2": "SUITE 202",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981225698",
            "telephone_number": "206-320-5687",
            "fax_number": "206-320-8145"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROVIDENCE AUDIOLOGY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-21",
        "last_updated": "2010-10-25",
        "status": "A",
        "authorized_official_last_name": "ELLIS",
        "authorized_official_first_name": "SANDRA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "206-320-5687",
        "authorized_official_credential": "AU.D., FAAA"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "WA",
            "license": "LD00001067",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Seattle Hearing and Balance Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Seattle, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.