Provider Demographics
NPI:1215918040
Name:KASPER-BRAITHWAITE, RONDA K (AUD MA)
Entity type:Individual
Prefix:MS
First Name:RONDA
Middle Name:K
Last Name:KASPER-BRAITHWAITE
Suffix:
Gender:F
Credentials:AUD MA
Other - Prefix:
Other - First Name:RHONDA
Other - Middle Name:
Other - Last Name:KASPER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:AUD MA
Mailing Address - Street 1:PO BOX 3649
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99220-3649
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:801 W 5TH AVE
Practice Address - Street 2:SUITE 205
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99204-2823
Practice Address - Country:US
Practice Address - Phone:509-838-2531
Practice Address - Fax:509-755-6580
Is Sole Proprietor?:No
Enumeration Date:2005-11-09
Last Update Date:2015-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALD00002338231H00000X
LD00002338237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8367625Medicaid
WAAB19360Medicare ID - Type Unspecified
WA8367625Medicaid