Provider Demographics
NPI:1043536345
Name:UW SPEECH & HEARING CLINIC
Entity type:Organization
Organization Name:UW SPEECH & HEARING CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINIC DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:B
Authorized Official - Last Name:ALARCON
Authorized Official - Suffix:
Authorized Official - Credentials:MS, CCC-SLP
Authorized Official - Phone:206-685-2212
Mailing Address - Street 1:4131 15TH AVE. NE
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98105-6299
Mailing Address - Country:US
Mailing Address - Phone:206-543-5440
Mailing Address - Fax:206-616-1185
Practice Address - Street 1:4131 15TH AVE. NE
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98105-6299
Practice Address - Country:US
Practice Address - Phone:206-543-5440
Practice Address - Fax:206-616-1185
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:UNIVERSITY OF WASHINGTON
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-04-12
Last Update Date:2010-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALD00002371231H00000X, 231HA2500X, 237600000X, 237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Multi-Specialty
No231HA2500XSpeech, Language and Hearing Service ProvidersAudiologistAssistive Technology SupplierGroup - Multi-Specialty
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid FitterGroup - Multi-Specialty
No237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument SpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA9051012Medicaid