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Organization

BALLARD SPEECH & HEARING CTR. P.S.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. CHARLES VIRGIL FULMER II AUD (AUDIOLOGIST)
(206) 789-7029
Entity
Organization

Contact information

Practice address
5428 BARNES AVE NW, SEATTLE, WA 98107-3839
(206) 789-7029
(206) 789-5485
Mailing address
5428 BARNES AVE NW, SEATTLE, WA 98107-3839
(206) 789-7029
(206) 789-5485

Taxonomy

Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
LD00000978
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1427137447
PERSONAL NPI
WA
Enumeration date
07/18/2008
Last updated
07/18/2008
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