Provider Demographics
NPI:1558424804
Name:WUTH, JAMES F (AUD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:F
Last Name:WUTH
Suffix:
Gender:M
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:805 MADISON ST
Mailing Address - Street 2:SUITE 901
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98104-1172
Mailing Address - Country:US
Mailing Address - Phone:206-264-8100
Mailing Address - Fax:
Practice Address - Street 1:515 MINOR AVE
Practice Address - Street 2:SUITE 150
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98104-2120
Practice Address - Country:US
Practice Address - Phone:206-622-9916
Practice Address - Fax:206-682-3012
Is Sole Proprietor?:No
Enumeration Date:2006-12-18
Last Update Date:2016-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALD00001031231HA2400X, 231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No231HA2400XSpeech, Language and Hearing Service ProvidersAudiologistAssistive Technology Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8339467Medicaid
WAWU1984OtherREGENCE
WA218190OtherLABOR & INDUSTRY
WAP00461228OtherPALMETTE / RR MEDICARE
WA8339467Medicaid
WA8866375Medicare PIN