Provider Demographics
NPI:1427038843
Name:CASTILLO, SHAWN (AUD)
Entity Type:Individual
Prefix:MRS
First Name:SHAWN
Middle Name:
Last Name:CASTILLO
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 1:4444 KALAMAZOO AVE SE
Mailing Address - Street 2:MCDONALD AUDIOLOGY AND HEARING HEALTH CARE
Mailing Address - City:KENTWOOD
Mailing Address - State:MI
Mailing Address - Zip Code:49508-4600
Mailing Address - Country:US
Mailing Address - Phone:616-455-9180
Mailing Address - Fax:
Practice Address - Street 1:4444 KALAMAZOO AVE SE
Practice Address - Street 2:MCDONALD AUDIOLOGY AND HEARING HEALTH CARE
Practice Address - City:KENTWOOD
Practice Address - State:MI
Practice Address - Zip Code:49508-4600
Practice Address - Country:US
Practice Address - Phone:616-455-9180
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-20
Last Update Date:2014-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL147.001102231H00000X
MI1601000633231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist