Healthcare Provider Details

I. General information

NPI: 1528154572
Provider Name (Legal Business Name): NORDSTROM INC & SUBSIDIARIES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/05/2006
Last Update Date: 06/16/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6191 S STATE ST STE 200
MURRAY UT
84107-7265
US

IV. Provider business mailing address

1617 6TH AVE ATTN: PROSTHESIS
SEATTLE WA
98101-1707
US

V. Phone/Fax

Practice location:
  • Phone: 801-261-4402
  • Fax:
Mailing address:
  • Phone: 206-454-4060
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number State

VIII. Authorized Official

Name: KRESHA B BRITTON
Title or Position: PROSTHESIS OFFICE MANAGER
Credential:
Phone: 206-454-4060