Provider Demographics
NPI:1174696272
Name:HEARING CONNECTION, LLC
Entity type:Organization
Organization Name:HEARING CONNECTION, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED AUDIOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:B
Authorized Official - Last Name:SHEETS
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:509-453-8600
Mailing Address - Street 1:1005 W WALNUT ST
Mailing Address - Street 2:STE 102
Mailing Address - City:YAKIMA
Mailing Address - State:WA
Mailing Address - Zip Code:98902-3360
Mailing Address - Country:US
Mailing Address - Phone:509-453-8600
Mailing Address - Fax:509-453-8616
Practice Address - Street 1:1005 W WALNUT ST
Practice Address - Street 2:STE 102
Practice Address - City:YAKIMA
Practice Address - State:WA
Practice Address - Zip Code:98902-3360
Practice Address - Country:US
Practice Address - Phone:509-453-8600
Practice Address - Fax:509-453-8616
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA7122021Medicaid
WA9054768Medicaid
WA48169OtherHEARPO PROVIDER #
WA211431OtherSTATE L&I GROUP NUMBER
WA8931873Medicaid
WA9165HEOtherREGENCE BLUE SHIELD GRP #
WA8931873Medicaid