Provider Demographics
NPI:1295872000
Name:HESS, GREGORY R (AUD)
Entity type:Individual
Prefix:
First Name:GREGORY
Middle Name:R
Last Name:HESS
Suffix:
Gender:M
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:303 POTTER ST
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98225-4924
Mailing Address - Country:US
Mailing Address - Phone:360-676-9771
Mailing Address - Fax:360-676-5313
Practice Address - Street 1:303 POTTER ST
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-4924
Practice Address - Country:US
Practice Address - Phone:360-676-9771
Practice Address - Fax:360-676-5313
Is Sole Proprietor?:No
Enumeration Date:2007-01-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALD00001024237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA133969OtherLABOR & INDUSTRY
WABE8989OtherREGENCE BLUE SHIELD
WAS26368Medicare UPIN