Individual provider Active NPI

Wade A Williams

  • Hearing Instrument Specialist
  • Kelso, WA
National Provider Identifier
1972748879
Registry record updated Apr 6, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hearing Instrument SpecialistTaxonomy code 237700000X
License
HA60263662 Issued in WA
Practice address
341 Three Rivers Dr.
Kelso, WA 98626-3100
Phone
(360) 200-5079
Fax
(208) 377-0313
NPI assigned
Dec 5, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hearing Instrument Specialist 237700000X HA-1667 ID
Hearing Instrument Specialist 237700000X HA60263662 WA Primary

Addresses

Primary practice location

341 Three Rivers Dr.
Kelso, WA 98626-3100

Mailing address

8800 SE Sunnyside Rd.
Ste. 300-N
Clackamas, OR 97015-5738
Phone (503) 659-5115

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
HA-1667IDMDHearing Instrument Specialist
HA60263662WAMDHearing Instrument Specialist

NPI Registry JSON

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

{
    "created_epoch": "1228435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1333670400000",
    "number": "1972748879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8800 SE SUNNYSIDE RD.",
            "address_2": "STE. 300-N",
            "city": "CLACKAMAS",
            "state": "OR",
            "postal_code": "970155738",
            "telephone_number": "503-659-5115",
            "fax_number": "208-377-0313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "341 THREE RIVERS DR.",
            "city": "KELSO",
            "state": "WA",
            "postal_code": "986263100",
            "telephone_number": "360-200-5079",
            "fax_number": "208-377-0313"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "WADE",
        "middle_name": "A",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-12-05",
        "last_updated": "2012-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "237700000X",
            "taxonomy_group": "",
            "desc": "Hearing Instrument Specialist",
            "state": "ID",
            "license": "HA-1667",
            "primary": false
        },
        {
            "code": "237700000X",
            "taxonomy_group": "",
            "desc": "Hearing Instrument Specialist",
            "state": "WA",
            "license": "HA60263662",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kelso, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2012; 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.