Provider Demographics
NPI:1356580310
Name:AMERICAN ADVANCED HEARING AID LLC
Entity type:Organization
Organization Name:AMERICAN ADVANCED HEARING AID LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JAMAL
Authorized Official - Middle Name:M
Authorized Official - Last Name:DASHTI
Authorized Official - Suffix:
Authorized Official - Credentials:HIS
Authorized Official - Phone:425-265-1100
Mailing Address - Street 1:121 SE EVERETT MALL WAY
Mailing Address - Street 2:SUITE B
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98208
Mailing Address - Country:US
Mailing Address - Phone:425-265-1100
Mailing Address - Fax:425-265-1199
Practice Address - Street 1:121 SE EVERETT MALL WAY
Practice Address - Street 2:SUITE B
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98208
Practice Address - Country:US
Practice Address - Phone:425-265-1100
Practice Address - Fax:425-265-1199
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-16
Last Update Date:2009-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60259511900332S00000X
WAHA00002879237700000X
WA602595119332S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes332S00000XSuppliersHearing Aid EquipmentGroup - Multi-Specialty
No237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument SpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8067696Medicaid
WA9058215Medicaid
WA215045OtherL & I
WA9058215Medicaid