Individual
ANUPA MUTYALA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AUD CCC-A
Contact information
Practice address
4800 SAND POINT WAY NE, M/S W6665, SEATTLE, WA 98105-3901
(206) 987-5467
(206) 987-3599
Mailing address
4678 177TH AVE SE, BELLEVUE, WA 98006-6517
(206) 987-5467
(206) 987-3599
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
—
—
231HA2400X
Assistive Technology Practitioner Audiologist
—
—
231HA2500X
Assistive Technology Supplier Audiologist
—
—
237600000X
Audiologist-Hearing Aid Fitter
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8437089
—
WA
01
—
LD00004077
PROFESSIONAL LICENSE NUMB
WA
Enumeration date
08/30/2006
Last updated
11/19/2019
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