Provider Demographics
NPI:1316133655
Name:HEARING & BALANCE LAB PC
Entity type:Organization
Organization Name:HEARING & BALANCE LAB PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:MALLAHAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:425-225-2626
Mailing Address - Street 1:15906 MILL CREEK BLVD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:MILL CREEK
Mailing Address - State:WA
Mailing Address - Zip Code:98012-1797
Mailing Address - Country:US
Mailing Address - Phone:425-225-2626
Mailing Address - Fax:425-225-2634
Practice Address - Street 1:15906 MILL CREEK BLVD
Practice Address - Street 2:SUITE 102
Practice Address - City:MILL CREEK
Practice Address - State:WA
Practice Address - Zip Code:98012-1797
Practice Address - Country:US
Practice Address - Phone:425-225-2626
Practice Address - Fax:425-225-2634
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-20
Last Update Date:2016-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty