Provider Demographics
NPI:1962518159
Name:SORENSON, KARI ANN (MS AUDIOLOGIST, CCC)
Entity type:Individual
Prefix:MS
First Name:KARI
Middle Name:ANN
Last Name:SORENSON
Suffix:
Gender:F
Credentials:MS AUDIOLOGIST, CCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:127 S WASHINGTON ST
Mailing Address - Street 2:#1
Mailing Address - City:MOSCOW
Mailing Address - State:ID
Mailing Address - Zip Code:83843-2866
Mailing Address - Country:US
Mailing Address - Phone:208-883-4242
Mailing Address - Fax:280-883-2885
Practice Address - Street 1:127 S WASHINGTON ST
Practice Address - Street 2:#1
Practice Address - City:MOSCOW
Practice Address - State:ID
Practice Address - Zip Code:83843-2866
Practice Address - Country:US
Practice Address - Phone:208-883-4242
Practice Address - Fax:280-883-2885
Is Sole Proprietor?:No
Enumeration Date:2006-08-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDAUD 1086231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IDAU498OtherBLUE CROSS
WA23274OtherGROUP HEALTH
IDAU498OtherBLUE CROSS