Provider Demographics
NPI:1295469484
Name:HERSHEY, MICHAEL ELI
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:ELI
Last Name:HERSHEY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:486 S OAK ST STE 105
Mailing Address - Street 2:
Mailing Address - City:COLVILLE
Mailing Address - State:WA
Mailing Address - Zip Code:99114-2751
Mailing Address - Country:US
Mailing Address - Phone:702-596-8867
Mailing Address - Fax:
Practice Address - Street 1:486 S OAK ST STE 105
Practice Address - Street 2:
Practice Address - City:COLVILLE
Practice Address - State:WA
Practice Address - Zip Code:99114-2751
Practice Address - Country:US
Practice Address - Phone:702-596-8867
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-13
Last Update Date:2023-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAHA-0401237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist