Provider Demographics
NPI:1780867069
Name:ANACORTES HEARING CENTER INC
Entity Type:Organization
Organization Name:ANACORTES HEARING CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:HOLLY
Authorized Official - Middle Name:A
Authorized Official - Last Name:KENNEDY
Authorized Official - Suffix:
Authorized Official - Credentials:AUD
Authorized Official - Phone:360-588-1956
Mailing Address - Street 1:3202 COMMERCIAL AVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:ANACORTES
Mailing Address - State:WA
Mailing Address - Zip Code:98221-4212
Mailing Address - Country:US
Mailing Address - Phone:360-588-1956
Mailing Address - Fax:360-588-0107
Practice Address - Street 1:3202 COMMERCIAL AVE
Practice Address - Street 2:SUITE B
Practice Address - City:ANACORTES
Practice Address - State:WA
Practice Address - Zip Code:98221-4212
Practice Address - Country:US
Practice Address - Phone:360-588-1956
Practice Address - Fax:360-588-0107
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-10
Last Update Date:2007-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALD00002957237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid FitterGroup - Single Specialty