Provider Demographics
NPI:1518994896
Name:PENINSULA HEARING INC
Entity type:Organization
Organization Name:PENINSULA HEARING INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CHIEF AUDIOLOGIST
Authorized Official - Prefix:MS
Authorized Official - First Name:MEGAN
Authorized Official - Middle Name:KAY
Authorized Official - Last Name:NIGHTINGALE
Authorized Official - Suffix:
Authorized Official - Credentials:AUD
Authorized Official - Phone:360-697-3061
Mailing Address - Street 1:19319 7TH AVE NE STE 102
Mailing Address - Street 2:
Mailing Address - City:POULSBO
Mailing Address - State:WA
Mailing Address - Zip Code:98370-7442
Mailing Address - Country:US
Mailing Address - Phone:360-697-3061
Mailing Address - Fax:360-697-2116
Practice Address - Street 1:19319 7TH AVE NE STE 102
Practice Address - Street 2:
Practice Address - City:POULSBO
Practice Address - State:WA
Practice Address - Zip Code:98370-7442
Practice Address - Country:US
Practice Address - Phone:360-697-3061
Practice Address - Fax:360-697-2116
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-26
Last Update Date:2024-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech
No332S00000XSuppliersHearing Aid EquipmentGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1107102OtherCHPW
192493100OtherUS DOL
WA7120413Medicaid
WA73468OtherL & I
WA9260019Medicaid
WA73468OtherL & I