Organization
ADVANCED HEARING AND SPEECH INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ANITA RAE GANTRY-DOTSON MSSLP/A,CCC (PRESIDENT)
(360) 740-8992
Entity
Organization
Contact information
Practice address
1570 N NATIONAL AVE, SUITE 101, CHEHALIS, WA 98532-2215
(360) 740-8992
(360) 740-8993
Mailing address
PO BOX 148, SALKUM, WA 98582-0148
(360) 740-8992
(360) 740-8993
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
—
—
235Z00000X
Speech-Language Pathologist
—
—
332S00000X
Hearing Aid Equipment
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7035900
MEDICAID, SPEECH
—
05
—
7126261
—
WA
01
—
8806567
PERSONAL NUMBER
—
01
—
9060328
HEARING AID
—
Enumeration date
03/25/2008
Last updated
03/31/2008
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