Provider Demographics
NPI:1619184090
Name:SILVA, MARY (AUD)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:
Last Name:SILVA
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 1:1311 S UNION AVE STE 102
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98405-1959
Mailing Address - Country:US
Mailing Address - Phone:253-759-3555
Mailing Address - Fax:253-759-2988
Practice Address - Street 1:2611 NE 125TH ST STE 238
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98125-4357
Practice Address - Country:US
Practice Address - Phone:206-526-2411
Practice Address - Fax:253-759-2988
Is Sole Proprietor?:No
Enumeration Date:2007-05-16
Last Update Date:2018-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALD00004430231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist