Provider Demographics
NPI:1356070486
Name:SONG, JAMIE (AUD)
Entity Type:Individual
Prefix:
First Name:JAMIE
Middle Name:
Last Name:SONG
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6014 S 127TH LN
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98178-5183
Mailing Address - Country:US
Mailing Address - Phone:253-218-9884
Mailing Address - Fax:
Practice Address - Street 1:1901 S 72ND ST STE A-14
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98408-1200
Practice Address - Country:US
Practice Address - Phone:253-753-2233
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-06
Last Update Date:2022-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist