Eidsvoog, Mara Louise

Eidsvoog, Mara Louise is an individual health care provider with primary practice located at 21701 76Th Ave W Ste 306 , Edmonds WA 98026-7536. She recently has only one registered license in Speech, Language and Hearing Service Providers / Hearing Instrument Specialist, which is considered as her primary health care specialty. Eidsvoog, Mara Louise can be contacted via phone (425) 582-8264.

Contact Information

Primary practice address
21701 76Th Ave W Ste 306 Edmonds WA 98026-7536
Phone: (425) 582-8264
Fax: (253) 759-2988
Website:
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Health care specialties

SpecialtyCodeLicense #State
Speech, Language and Hearing Service Providers / Hearing Instrument Specialist 237700000X HA60740882 Washington

Profile Details

NPI number 1902328024
LBN Legal business name Eidsvoog, Mara Louise
Credentials HIS
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 11th, 2017
Last updated Dec 13th, 2018 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1902328024 NPPES
Washington MEDICAID 1091043

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