Mara Louise Eidsvoog, HIS

Primary specialty

Hearing Instrument SpecialistTaxonomy code 237700000X

License

HA60740882 Issued in WA

Practice address

21701 76TH Ave W Ste 306
Edmonds, WA 98026-7536

Phone

(425) 582-8264

Fax

(253) 759-2988

NPI assigned

Jul 11, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Hearing by Design, Inc

  • Hearing Aid Equipment
  • Tacoma, WA
  • NPI 1174715015

  Hearing Instrument Specialist

  NPD (past)

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

{
    "created_epoch": "1499731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1544659200000",
    "number": "1902328024",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1311 S UNION AVE STE 102",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984051959",
            "telephone_number": "253-759-3555",
            "fax_number": "253-759-2988"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21701 76TH AVE W STE 306",
            "city": "EDMONDS",
            "state": "WA",
            "postal_code": "980267536",
            "telephone_number": "425-582-8264",
            "fax_number": "253-759-2988"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EIDSVOOG",
        "first_name": "MARA",
        "middle_name": "LOUISE",
        "name_prefix": "Ms.",
        "credential": "HIS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-11",
        "last_updated": "2018-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "237700000X",
            "taxonomy_group": "",
            "desc": "Hearing Instrument Specialist",
            "state": "WA",
            "license": "HA60740882",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1091043",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Anne W Egleston Gerich, FNP BC
• William Frederick Ehni, M.D.
• Eide Neurolearning Clinic, Inc P.S.
• Brock Leonard Eide, M.D. M.A.
• Fernette Fang Eide, M.D.
• Bailey Elizabeth Eley, NP
• Francxs P Elkins-Placide, PA-C
• Ellie'S Caring Hand Adult Family Home LLC
• Riley Winter Ellinwood
• Nicole Ellyson, RN

• Hearing Instrument Specialist in Edmonds, WA
• Providers in Edmonds, WA by specialty
• Hearing Instrument Specialist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2018; 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.