Provider Demographics
NPI:1164447793
Name:CHURCHILL, SHASHI LYNN (AUD)
Entity Type:Individual
Prefix:DR
First Name:SHASHI
Middle Name:LYNN
Last Name:CHURCHILL
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:DR
Other - First Name:SHASHI
Other - Middle Name:L
Other - Last Name:CHURCHILL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:AUD
Mailing Address - Street 1:49 FRONT ST N
Mailing Address - Street 2:
Mailing Address - City:ISSAQUAH
Mailing Address - State:WA
Mailing Address - Zip Code:98027-3237
Mailing Address - Country:US
Mailing Address - Phone:425-391-3343
Mailing Address - Fax:
Practice Address - Street 1:13119 SEATTLE HILL RD STE 102
Practice Address - Street 2:
Practice Address - City:SNOHOMISH
Practice Address - State:WA
Practice Address - Zip Code:98296-3402
Practice Address - Country:US
Practice Address - Phone:425-332-3537
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-13
Last Update Date:2023-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALD00002967231H00000X
WA61428813237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist
No231H00000XSpeech, Language and Hearing Service ProvidersAudiologist