Provider Demographics
NPI:1417055997
Name:RASZLER, SCOTT J (MA CCC-A)
Entity Type:Individual
Prefix:
First Name:SCOTT
Middle Name:J
Last Name:RASZLER
Suffix:
Gender:M
Credentials:MA CCC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22180 OLYMPIC COLLEGE WAY
Mailing Address - Street 2:SUITE 205
Mailing Address - City:POULSBO
Mailing Address - State:WA
Mailing Address - Zip Code:98370-6664
Mailing Address - Country:US
Mailing Address - Phone:360-697-1300
Mailing Address - Fax:360-697-3238
Practice Address - Street 1:22180 OLYMPIC COLLEGE WAY
Practice Address - Street 2:SUITE 205
Practice Address - City:POULSBO
Practice Address - State:WA
Practice Address - Zip Code:98370-6664
Practice Address - Country:US
Practice Address - Phone:360-697-1300
Practice Address - Fax:360-697-3238
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2011-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALD00002050237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA9029752Medicaid
WA7037948Medicaid
WA7037948Medicaid
WAR34220Medicare UPIN