Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mrs. Mary Disselkoen

Individual provider Audiologist · NPI 1457596090

Mrs. Mary Disselkoen is an Audiologist in Grand Rapids, Michigan. Licensed in Michigan. Registered with an NPI since 2008.

Licensed in
MI
In the registry since
2008
Specialties on file
3

Practice location Address checks out

1353 Van Auken St SE
Grand Rapids, MI 49508-2516
Phone: (616) 819-2685
Fax: (616) 819-2684
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Audiologist (primary) Taxonomy 231H00000X · Licence 1601000230 (MI)
Assistive Technology Practitioner Audiologist Taxonomy 231HA2400X · Licence 1601000230 (MI)
Audiologist-Hearing Aid Fitter Taxonomy 237600000X · Licence 1601000230 (MI)

Record details

NPI number1457596090
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedDecember 11, 2008
Last updated in NPPESDecember 11, 2008

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