Provider Demographics
NPI:1710076260
Name:PRIMM, JENNY DENISE (HEARING SPECIALIST)
Entity Type:Individual
Prefix:MRS
First Name:JENNY
Middle Name:DENISE
Last Name:PRIMM
Suffix:
Gender:F
Credentials:HEARING SPECIALIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6700 WASHINGTON AVE S
Mailing Address - Street 2:
Mailing Address - City:EDEN PRAIRIE
Mailing Address - State:MN
Mailing Address - Zip Code:55344-3405
Mailing Address - Country:US
Mailing Address - Phone:612-351-1529
Mailing Address - Fax:
Practice Address - Street 1:10909 PORTLAND AVE E STE T
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98445-5252
Practice Address - Country:US
Practice Address - Phone:253-476-4300
Practice Address - Fax:253-537-4900
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2018-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA237600000X
WA2217237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter