Provider Demographics
NPI:1699366336
Name:CARLSON, HANNAH JULIA (AUD)
Entity Type:Individual
Prefix:DR
First Name:HANNAH
Middle Name:JULIA
Last Name:CARLSON
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 1:2804 104TH PL SE
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98208-4454
Mailing Address - Country:US
Mailing Address - Phone:425-316-3665
Mailing Address - Fax:
Practice Address - Street 1:118 S 12TH ST
Practice Address - Street 2:
Practice Address - City:MOUNT VERNON
Practice Address - State:WA
Practice Address - Zip Code:98274-4036
Practice Address - Country:US
Practice Address - Phone:360-336-2178
Practice Address - Fax:360-336-1995
Is Sole Proprietor?:No
Enumeration Date:2021-01-26
Last Update Date:2022-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALD61148432237600000X, 231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter