Individual
ROMAN E THEISEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
NBC HIS
Contact information
Practice address
12211 E BROADWAY AVE STE 4, SPOKANE VALLEY, WA 99206-6132
(509) 924-3459
(509) 924-3459
Mailing address
12211 E BROADWAY AVE STE 4, SPOKANE VALLEY, WA 99206-6132
(509) 924-3459
(509) 924-3459
Taxonomy
Speciality
Code
Description
License number
State
237700000X
Hearing Instrument Specialist
Primary
666
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0107757
LABOR & INDUSTRIES
WA
01
—
02019
HEAR PO
WA
05
—
9034075
—
WA
Enumeration date
04/23/2007
Last updated
07/09/2007
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