Provider Demographics
NPI:1700575321
Name:ROZNOWSKI, EMILY SUSAN (AUD)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:SUSAN
Last Name:ROZNOWSKI
Suffix:
Gender:F
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:PO BOX 5299
Mailing Address - Street 2:MS: 820-5-PCO
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98415-0299
Mailing Address - Country:US
Mailing Address - Phone:253-459-8231
Mailing Address - Fax:
Practice Address - Street 1:1909 S 72ND ST # A-1
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98408-1203
Practice Address - Country:US
Practice Address - Phone:253-697-5200
Practice Address - Fax:253-864-3939
Is Sole Proprietor?:No
Enumeration Date:2023-05-01
Last Update Date:2024-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR31080231H00000X
WALD61560625231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist