NPI 1356573356 · live from the CMS NPI Registry
Sara Michelle Bodack, Au.D.
Audiologist in Vancouver, WA. National Provider Identifier 1356573356, active.
NPI record
| NPI | 1356573356 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Audiologist 231H00000X |
| Practice location | 2525 Ne 139th St Ste 230, Vancouver, WA 98686 |
| Practice phone | 360-882-2778 |
| Mailing address | Po Box 4825, Portland, OR 97208 |
| Enumerated | August 10, 2009 |
| Last updated | September 30, 2019 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Audiologist | 231H00000X | 80250 (TX) |
| Audiologist primary | 231H00000X | LD60953985 (WA) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.