Provider Demographics
NPI:1609028935
Name:VOCAL LABS FACTORY OUTLET
Entity Type:Organization
Organization Name:VOCAL LABS FACTORY OUTLET
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINSTRATIVE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JON
Authorized Official - Middle Name:E
Authorized Official - Last Name:PANNETTE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:253-604-4562
Mailing Address - Street 1:104 39TH AVE SW
Mailing Address - Street 2:SUITE B
Mailing Address - City:PUYALLUP
Mailing Address - State:WA
Mailing Address - Zip Code:98373-3621
Mailing Address - Country:US
Mailing Address - Phone:253-604-4562
Mailing Address - Fax:360-736-2652
Practice Address - Street 1:104 39TH AVE SW
Practice Address - Street 2:SUITE B
Practice Address - City:PUYALLUP
Practice Address - State:WA
Practice Address - Zip Code:98373-3621
Practice Address - Country:US
Practice Address - Phone:253-604-4562
Practice Address - Fax:360-736-2652
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:VOCAL LABS, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-10-17
Last Update Date:2008-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA609237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument SpecialistGroup - Single Specialty