Provider Demographics
NPI:1891967071
Name:INTEGRITY HEARING SERVICES, PS
Entity Type:Organization
Organization Name:INTEGRITY HEARING SERVICES, PS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUDIOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:DANETTE
Authorized Official - Middle Name:P
Authorized Official - Last Name:JACKSON
Authorized Official - Suffix:
Authorized Official - Credentials:MA, CCC-A
Authorized Official - Phone:253-476-4327
Mailing Address - Street 1:7515 CUSTER RD W
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98499-8138
Mailing Address - Country:US
Mailing Address - Phone:253-476-4327
Mailing Address - Fax:253-476-0585
Practice Address - Street 1:7525 CUSTER RD W
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:WA
Practice Address - Zip Code:98499
Practice Address - Country:US
Practice Address - Phone:253-476-4327
Practice Address - Fax:253-476-0585
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-28
Last Update Date:2018-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALD00001210261QH0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech
Provider Identifiers
StateIdentifier IDID TypeIssuer
1013034255OtherPERSONAL NPI
WA7127665Medicaid
WAS43280OtherUPIN
WA9058553Medicaid