Provider Demographics
NPI:1023146065
Name:NYE, JEFFREY D (CCC-A)
Entity type:Individual
Prefix:
First Name:JEFFREY
Middle Name:D
Last Name:NYE
Suffix:
Gender:M
Credentials:CCC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1424 N MCDONALD RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:SPOKANE VALLEY
Mailing Address - State:WA
Mailing Address - Zip Code:99216-6017
Mailing Address - Country:US
Mailing Address - Phone:509-928-7272
Mailing Address - Fax:509-928-7346
Practice Address - Street 1:1424 N MCDONALD RD
Practice Address - Street 2:SUITE 101
Practice Address - City:SPOKANE VALLEY
Practice Address - State:WA
Practice Address - Zip Code:99216-6017
Practice Address - Country:US
Practice Address - Phone:509-928-7272
Practice Address - Fax:509-928-7346
Is Sole Proprietor?:No
Enumeration Date:2007-03-01
Last Update Date:2012-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALL00002341231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist