Provider Demographics
NPI:1003208018
Name:LINK AUDIOLOGY, LLC
Entity Type:Organization
Organization Name:LINK AUDIOLOGY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:EVAN
Authorized Official - Middle Name:CHARLES
Authorized Official - Last Name:GROLLEY
Authorized Official - Suffix:
Authorized Official - Credentials:AUD, CCC-A
Authorized Official - Phone:360-551-4800
Mailing Address - Street 1:9576 RIDGETOP BLVD NW
Mailing Address - Street 2:SUITE 103
Mailing Address - City:SILVERDALE
Mailing Address - State:WA
Mailing Address - Zip Code:98383-8554
Mailing Address - Country:US
Mailing Address - Phone:360-551-4800
Mailing Address - Fax:
Practice Address - Street 1:9576 RIDGETOP BLVD NW
Practice Address - Street 2:SUITE 103
Practice Address - City:SILVERDALE
Practice Address - State:WA
Practice Address - Zip Code:98383-8554
Practice Address - Country:US
Practice Address - Phone:360-551-4800
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-27
Last Update Date:2015-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALD60281561231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty