Healthcare Provider Details
I. General information
NPI: 1568488955
Provider Name (Legal Business Name): NORDSTROM INC & SUBSIDIARIES
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/15/2006
Last Update Date: 06/17/2015
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
8075 TYSONS CORNER CTR
MCLEAN VA
22102-4505
US
IV. Provider business mailing address
1617 6TH AVE ATTN: PROSTHESIS
SEATTLE WA
98101-1707
US
V. Phone/Fax
- Phone: 703-761-1121
- Fax:
- Phone: 206-454-4060
- Fax: 206-454-1279
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 335E00000X |
| Taxonomy | Prosthetic/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