Provider Demographics
NPI:1568030690
Name:SMITH, TRISTA ELIZABETH (AUD, CCC-A)
Entity Type:Individual
Prefix:
First Name:TRISTA
Middle Name:ELIZABETH
Last Name:SMITH
Suffix:
Gender:F
Credentials:AUD, CCC-A
Other - Prefix:
Other - First Name:TRISTA
Other - Middle Name:
Other - Last Name:HOOLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2200 W MEEKER ST APT Q203
Mailing Address - Street 2:
Mailing Address - City:KENT
Mailing Address - State:WA
Mailing Address - Zip Code:98032-3510
Mailing Address - Country:US
Mailing Address - Phone:970-442-1869
Mailing Address - Fax:
Practice Address - Street 1:222 2ND ST NE
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:WA
Practice Address - Zip Code:98002-5040
Practice Address - Country:US
Practice Address - Phone:253-833-4050
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-15
Last Update Date:2021-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist