Provider Demographics
NPI:1871651257
Name:FEDERAL CERTIFIED HEARING CENTER, INC
Entity Type:Organization
Organization Name:FEDERAL CERTIFIED HEARING CENTER, INC
Other - Org Name:FEDERAL CERTIFIED HEARING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DEBBI
Authorized Official - Middle Name:D
Authorized Official - Last Name:DANIELS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:360-855-1207
Mailing Address - Street 1:PO BOX 272
Mailing Address - Street 2:
Mailing Address - City:SEDRO WOOLLEY
Mailing Address - State:WA
Mailing Address - Zip Code:98284-0272
Mailing Address - Country:US
Mailing Address - Phone:360-855-1207
Mailing Address - Fax:360-855-1407
Practice Address - Street 1:330 HWY 20 BLDG A
Practice Address - Street 2:
Practice Address - City:SEDRO WOOLLEY
Practice Address - State:WA
Practice Address - Zip Code:98284
Practice Address - Country:US
Practice Address - Phone:360-855-1207
Practice Address - Fax:360-855-1407
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-05
Last Update Date:2019-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA2075237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid FitterGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0214102OtherDEPT. OF LABOR & INDUSTRI
WA9059049Medicaid
WA148537300OtherOWCP
WA0214097OtherDEPT OF LABOR & INDUSTRIE
WA0214104OtherDEPT. OF LABOR & INDUSTRI