Provider Demographics
NPI:1922484336
Name:CHAI, SARA HYUNJUNG (AUD)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:HYUNJUNG
Last Name:CHAI
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:HYUNJUNG
Other - Middle Name:
Other - Last Name:CHAI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 25608
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84125-0608
Mailing Address - Country:US
Mailing Address - Phone:206-320-4476
Mailing Address - Fax:206-568-7043
Practice Address - Street 1:600 BROADWAY STE 200
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98122-5373
Practice Address - Country:US
Practice Address - Phone:206-215-1770
Practice Address - Fax:206-215-1771
Is Sole Proprietor?:No
Enumeration Date:2015-08-07
Last Update Date:2021-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALD60576392237600000X, 231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1922484336Medicaid