Healthcare Provider Details

I. General information

NPI: 1215262738
Provider Name (Legal Business Name): SOUND HEALTH MEDICAL SUPPLY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/16/2009
Last Update Date: 10/14/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10130 SW NIMBUS AVE STE D9
TIGARD OR
97223
US

IV. Provider business mailing address

2811 S 12TH ST
TACOMA WA
98405-2746
US

V. Phone/Fax

Practice location:
  • Phone: 503-639-9501
  • Fax: 503-639-9634
Mailing address:
  • Phone: 253-274-5000
  • Fax: 253-572-3111

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332BP3500X
TaxonomyParenteral & Enteral Nutrition Supplies (DME)
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number State

VIII. Authorized Official

Name: COURTNEY A TEBBS
Title or Position: PRESIDENT
Credential:
Phone: 253-225-6770