Provider Demographics
NPI:1730763863
Name:HOOGLAND, ELENA (AUD)
Entity type:Individual
Prefix:
First Name:ELENA
Middle Name:
Last Name:HOOGLAND
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19319 7TH AVE NE STE 102
Mailing Address - Street 2:
Mailing Address - City:POULSBO
Mailing Address - State:WA
Mailing Address - Zip Code:98370-7442
Mailing Address - Country:US
Mailing Address - Phone:360-697-3061
Mailing Address - Fax:360-697-2116
Practice Address - Street 1:1308 W SIMS WAY
Practice Address - Street 2:
Practice Address - City:PORT TOWNSEND
Practice Address - State:WA
Practice Address - Zip Code:98368-3060
Practice Address - Country:US
Practice Address - Phone:360-379-5458
Practice Address - Fax:360-379-5486
Is Sole Proprietor?:No
Enumeration Date:2021-05-05
Last Update Date:2024-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALD61188973231H00000X, 237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter