Individual
BRENDA LYNNE HALTOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
HEARING INSTUMENT SP
Contact information
Practice address
830 E 8TH ST, PORT ANGELES, WA 98362-6419
(360) 452-2228
(360) 457-9666
Mailing address
830 E 8TH ST, PORT ANGELES, WA 98362-6419
(360) 452-2228
(360) 457-9666
Taxonomy
Speciality
Code
Description
License number
State
237700000X
Hearing Instrument Specialist
Primary
2055
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0117480
WA. STATE LABOR AND INDUSTRIES
WA
05
—
9054685
—
WA
Enumeration date
11/10/2015
Last updated
11/10/2015
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