Healthcare Provider Details

I. General information

NPI: 1891050902
Provider Name (Legal Business Name): RAINIER SURGICAL INCORPORATED
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/05/2012
Last Update Date: 02/19/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

555 116TH AVE NE SUITE 180
BELLEVUE WA
98004-5232
US

IV. Provider business mailing address

1144 29TH ST NW
AUBURN WA
98001-2465
US

V. Phone/Fax

Practice location:
  • Phone: 425-453-0555
  • Fax:
Mailing address:
  • Phone: 206-409-0500
  • Fax:

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 Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number State

VIII. Authorized Official

Name: SHERYL PRICE
Title or Position: DIRECTOR OF REIMBURSEMENT
Credential:
Phone: 503-493-8288