Provider Demographics
NPI:1114146503
Name:CERTIFIED HEARING INC.
Entity Type:Organization
Organization Name:CERTIFIED HEARING INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:BRENDA
Authorized Official - Middle Name:L
Authorized Official - Last Name:HALTOM
Authorized Official - Suffix:
Authorized Official - Credentials:BC HIS
Authorized Official - Phone:360-452-2228
Mailing Address - Street 1:819 GEORGIANA ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:PORT ANGELES
Mailing Address - State:WA
Mailing Address - Zip Code:98362-3511
Mailing Address - Country:US
Mailing Address - Phone:360-452-2228
Mailing Address - Fax:360-457-9666
Practice Address - Street 1:819 GEORGIANA ST
Practice Address - Street 2:SUITE B
Practice Address - City:PORT ANGELES
Practice Address - State:WA
Practice Address - Zip Code:98362-3511
Practice Address - Country:US
Practice Address - Phone:360-452-2228
Practice Address - Fax:360-457-9666
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument SpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA9054685Medicaid
WA117480OtherL & I